Increased morbidity following the introduction of remote afterloading, with increased dose rate, for cancer of the cervix.

A retrospective review of the treatment of cancer of the cervix compared the 3-year period before and after the introduction of remote afterloading using a "low dose rate' Selectron. Data was collected on 270 patients. Compared to manually loaded caesium the dose rate to point A was doubled with Selectron and a dose reduction of 20% was adopted to compensate for the expected increased effectiveness. The combined grade 2 and 3 complication rates were 12% with manually loaded caesium and 32% with Selectron at the higher dose rate. Survival and local control rates were similar.