[Late sequelae and complications in exclusive high voltage radiotherapy for carcinoma of the cervix uteri (author's transl)].
This study deals with 524 cases of uterine cervix (except stade IV cases) completely treated at the Foundation Curie with esclusive radiotherapy from from 1962 to 1968. The irradiation techniques, as well as the doses given to the tumor and to the critical organs are stated. The various sequelae and complications are described, according to the class and severity. The cases are divided into two groups: 257 cured patients and 267 dead patients. For the cured patients, half of them (49%) had no trouble at all. Among the 130 remaning cases, 16% presented with mild troubles, 23% with moderate sequelae, 9% with marked complications and 3% with severe complications leading to an infirmity. The rectal troubles are frequent (55% of all the troubles) in 40% of the patients; though rarely, they can be severe (6% of the cases). They appear relatively early. The bladder troubles rank second (37% of all the troubles) in 20% of the patients; never severe and without any renal effect, they are more delayed than the former. The skin and soft tissues troubles are only a few (5%) for 5% of the patients. They are mostly mild and moderate. One skin necrosis was noted due for a large part to the very poor general conditions of the patient. The bone troubles are always classified here as marked or severe; they are rare (2,6%) in 2,3% of the patients. Their treatment is satisfactory. One single case of bilateral femur neck fracture gave a permanent infirmity. We have noted no nervous trouble, nor urinary trouble other than the bladder ones, nor bowel troubles aprt from a mild and transient sigmoiditis. The genital troubles noted in 21% of the patients are mostly vaginal adhesion in women over 60 years of age. The sexual troubles, very difficult to analyse, have not been studied here. The treatments of these various troubles have generally been simple, not very compelling, and effective. Only eight patients with severe complications (3%) underwent important therapeutics (fecal diversion, none surgery) and kept an infirmity. One patient (0,4%) died during the post-operative course. For the dead patients, the study is less significant, because of the neoplastic evolution and of the rather short survival. This fact explains that 20% only of the patients (versus 51%) presented with 106 troubles (versus 304). The rectal troubles remain frequent 33%) of the cases), though the bladder troubles, more delayed, are very less numerous (1,8% of the patients). The bone complications are similar in number and quality (2,2% of the patients).
D000328:Adult; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology; D006801:Humans; D008722:Methods; D008875:Middle Aged; D010025:Osteoradionecrosis; D011832:Radiation Injuries; D011855:Radiodermatitis; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*; D012002:Rectal Diseases / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*
Les séquelles et complications tardives de la radiothérapie exclusive de haute énergie des carcinomes du col utérin