title: Treatment of advanced cancer of the cervix with transperineal interstitial irradiation.
abstract: A pilot study using transperineal interstitial implantation to the parametrium in patients with locally advanced carcinoma of the cervix or with distorted anatomy is presented. Twenty-one consecutive patients (2 cervical stump Stage IB, 3 Stage IIB, 15 Stage IIIB, 1 Stage IVA) received one (12) or two (9) implants following 40-45 Gy whole pelvis external irradiation. In addition 8 patients underwent staging laparotomies concurrently with the first implant procedure. Control of the pelvic tumor was accomplished in 18 of 21 patients (85%) with a mean follow-up of 26 months (range 15 to 48 months). Seven patients (33%) developed long term complications (fistula 3, superficial necrosis of the vagina 1, severe proctitis or cystitis 3). Six of the complications occurred in 8 patients (75%) who had radioactive sources placed on the surface of the vaginal obturator as a substitute for the lack of tandem. In contrast, only 1 in the remaining 13 patients (8%) who did not have obturator sources placed, developed long term complications.
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007495:Iridium / Q000008:administration & dosage*; D008875:Middle Aged; D011868:Radioisotopes / Q000008:administration & dosage*; D011879:Radiotherapy Dosage; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*
chemical_list: D011868:Radioisotopes; D007495:Iridium