[New experiences in primary radiotherapy for vaginal carcinoma with notes on a multistage refined target volume concept].

Based on an analysis of a small new series of carcinomas of the vagina, observed in St. Georges General Hospital, Hamburg, a five year cure rate of more than 59% as a result of radiotherapy alone in 27 cases has been stated. Compared with former statistical information this effect represents a highly significant improvement. This improvement can be attributed to an individualized use of localised curie therapy. Performed with the flexible application of 127 Cs vaginal cylinders adapted to the individual anatomic extention of tumours. Apart from this individual adaption to the tumour size and site the method of curie therapy includes full utilisation of the space available within the genital tract. It is combined with a telecobalt treatment performed as a 4-axis-180 degrees-rotation directed the lateral parts of the true pelvis. The study gives a chance to discuss the target volume concept for combined radiotherapy of gynecological cancers. It is distinguished between target volumes of 1st, 2nd and 3rd order. The difficulties arising when the different components of combined radiotherapy of gynecological tumours have to be summed up, cannot easily be overcome. Further research with this field seems to be desirable.