[Exclusive radiotherapy (cobalt teletherapy-radium therapy) in epithelioma of the uterine cervix. 400 cases treated between 1959 and 1969].
The author presents results of 420 cases of epithelioma of the cervix of the uterus treated between 1959 and 1969, using exclusively physical agents such as cobalt therapy and radium therapy. 399 cases are analysed. 9 patients could not be traced and 12 died intercurrently. We have adopted the 1969 U.I.C.C. classification. External irradiation alwyas preceded radium therapy and its importance varied according to the stage: however, doses of 2,000 to 5,000 rads were used at the rate of 1,000 rads weekly for two to five weeks; this was followed by classical radium therapy (Paris method) with colpostat and uterine sound. The number of mgh was consequently reduced and the dose administered was inversely proportional to that of the external irradiation. On the whole, tolerance was good in this type of treatment. Complications were mainly limited to a few minor intestinal disorders; in belated sequelae, these disorders were not more than those usually noted. Results after five years reveal only one death out of 19 for stage T1 lesions. Recoveries are distributed as follows: 72 out of 93 stage T2a lesions (77%), 46 out of 87 stage T2b lesions (53%), 54 out of 131 stage T3a lesions (41%) and 13 out of 46 stage T3b lesions (28%). However, results according to period are better. For the 1967 to 1969 period, results were 92%, 62%, 53% and 30% for stages T2a, T2b, T3a and T3b respectively. Improvement in results could be due to external irradiation. This sterilizes pelvic macroscopic or microscopic extensions and decreases inflammatory phenomena and the volume of the cervix of the uterus. These changes facilitate radium therapy which remains an indispensable arm for sterilizing primary lesions. The author compares his results with those of the literature. He develops arguments for techniques which associate external irradiation and radium therapy in a well defined order. These techniques are particularly important for stages T2b or T3 in which lymph gland lesions are common and where doses of about 5,000 and 6,000 rads are necessary for sterilization. Possibilities of improving future results are analysed. Particular attention should be paid to the lumbo-aortic volume; lymph gland metastasis are frequent here and should be treated continuously with the pelvic volume.
D003037:Cobalt Radioisotopes; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011867:Radioisotope Teletherapy; D011879:Radiotherapy Dosage; D011883:Radium / Q000627:therapeutic use*; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*
D003037:Cobalt Radioisotopes; D011883:Radium
Radiothérapie exclusive (télécobalthérapie-curiethérapie) dans l'épithélioma du col utérin. 400 cas traités entre 1959 et 1969