Kim R Y, Levy D S, Brascho D J, Hatch K D
Radiology. 1983 Apr;147(1):249-51. doi: 10.1148/radiology.147.1.6681912.
All cases of uterine perforation occurring during intracavitary application for carcinoma of the cervix over a 13-year period (1968-1981) were reviewed. There were 14 perforations out of 799 applications in 622 patients, for an incidence of 2.25% of patients and 1.75% of applications. In most cases, it is sufficient to halt the application and carefully monitor the patient, as supported by the uneventful post-perforation course in 12 cases. Nine patients (64%) underwent subsequent intracavitary application without further complications; of these, 8 are still living or died without evidence of tumor. In the other 5, it was impossible to locate the cervical canal on subsequent applications. Alternative treatments, results of therapy, and analysis of failures are presented. The authors conclude that there is no direct evidence that uterine perforation alters the prognosis following radiation therapy for carcinoma of the cervix.
回顾了1968年至1981年这13年间，在子宫腔内应用镭进行宫颈癌治疗过程中发生子宫穿孔的所有病例。622例患者共进行了799次镭腔内治疗，其中发生14例穿孔，患者穿孔发生率为2.25%，治疗次数的穿孔发生率为1.75%。多数情况下，停止治疗并仔细监测患者即可，12例穿孔后病情平稳支持这一点。9例患者（64%）随后继续进行腔内治疗且未出现进一步并发症；其中8例仍存活或死亡时无肿瘤证据。另外5例患者，后续治疗时无法找到宫颈管。文中还介绍了替代治疗方法、治疗结果及失败原因分析。作者得出结论，没有直接证据表明子宫穿孔会改变宫颈癌放疗后的预后。
