[Outcome and complications of treatment by intracavitary afterloading radiotherapy in 143 patients with cervical cancer].

From May 1985 to Dec. 1987, 143 patients with cervical cancer were treated by intracavitary interposed with external irradiation to the pelvis using two parallel opposing fields alternatively. In these cases 68 were in stage II, 74 in stage III and 1 in stage IV. Buchler afterloading system with Cs-137 was applied for intracavitary treatment, the total dose at point A was from 40 Gy to 60 Gy. 10 MV X-ray was delivered for external irradiation, the sum of parauterine tissue dosage was 40 to 50 Gy. The over-all 5-year survival rate of the whole series after radiotherapy was 71.3%, with 80.9% for stage II and 63.5% for stage III. The frequency of delayed rectal and bladder reactions was 8.4% and 9.8% respectively, they were correlated with the over-dose at mid-axis, for example, in most patients with rectal and bladder reaction the dose absorbed by rectum was more than 30 Gy. In order to reduce the delayed complications and to decrease the dosage at mid-axis the authors have taken the following measures: (1) the adopted partial whole pelvic external irradiation before intracavitary radiotherapy. (2) the reduced number of fractions of intracavitary afterloading irradiation. (3) the adjusted dose distribution designed according to the individual situation.