[Influence of the topographic situation of the uterus upon the irradiation planning in case of carcinoma of the cervix].

The authors demonstrated by means of computed tomography that some problems are offered by the standardized method of primary radiotherapy in case of carcinomas of the cervix. Especially when a low-dose curietherapy is applied without dose monitor, a radiation exposure of bladder and rectum exceeding the tolerance limit or a underdosage in the target volume are possible due to variable positions of the uterus and different thicknesses of the uterus wall, above all in the region of the cervix. The rate of complications can also be increased by a false, eccentric position of the intra-uterine applicator if the latter does not follow the cervical canal. In nearly half of 61 patients with carcinomas of the cervix of stage I or III according to FIGO, computed tomography scanning showed a false position of the intra-uterine applicator probe. Besides the correction of the probe position, the problem can be solved by a dose reduction and use of shorter applicators or by a modified relation between brachytherapy and percutaneous therapy.