title: Long term results of Cathetron high dose rate intracavitary radiotherapy in the treatment of carcinoma of the cervix.
abstract: Between 1967 and 1974, 371 patients with carcinoma of the cervix have been treated by a combination of external beam radiotherapy and fractionated high dose rate brachytherapy using the Cathetron. A retrospective review was undertaken in 1986 and median follow-up time was 6 years. Life table analysis of survival and complications to 16 years was undertaken. International Federation of Gynaecology and Obstetrics (FIGO) stage distribution was 26%, 46% and 28% for Stages I, II and III, respectively, and 5 year survival was likewise 94% 63% and 37%. Age and histological type or grade were not found to influence survival. Recurrent disease was recorded in 142 patients; the first site was within the pelvis in 25% and as distant metastases in 17%. Following development of pelvic recurrence median survival was 28 weeks. Salvage surgery was performed in 32 patients, of whom five probably obtained survival benefit. Significant late morbidity was seen in a total of 71 patients (19%); in seven patients this was at more than one site. Late morbidity to the small bowel was recorded as Grade 2 in 10 patients and Grade 3 in 13; to the rectum, Grade 2 in 10 patients and Grade 3 in two patients; to the bladder, Grade 2 in 15 patients and to the vagina Grade 2 in 29 patients. Median time to onset for small bowel morbidity was 14 months, for rectum 18 months, for vagina 20 months and for bladder 52 months. 82% of all late morbidity had been seen by 5 years of follow-up, no case of late morbidity of recurrence was seen between 11 and 18 years of follow-up. These results are comparable to those reported for other methods in use at the time the patients were treated.
authors.affiliation: University Department of Radiotherapy, Cookridge Hospital, Leeds, UK.
authors.forename: G G
authors.initials: GG
authors.lastname: Khoury
authors.forename: A S
authors.initials: AS
authors.lastname: Bulman
authors.forename: C A
authors.initials: CA
authors.lastname: Joslin
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D001918:Brachytherapy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*