SIGNIFICANCE OF POSTOPERATIVE IRRADIATION IN CARCINOMA OF THE CERVIX: A TEN YEAR SURVEY

¹ Professor of Radiology, Columbia University; Director, Department of Radiotherapy, Francis Delafield Hospital, New York, New York.

The summary of this study can be very short. I set out to answer 3 questions, namely:

1. Can total pelvic irradiation be tolerated after a radical hysterectomy has been performed?

2. Will late complications outweigh the gain of the combined procedure?

3. Have the survival results improved with the 2 methods of treatment?

All 3 questions can be answered in the affirmative.

Total pelvic irradiation with a tumor dose of 4,000-5,000 rads delivered in 4-5 weeks time has been tolerated extremely well and the late complications have been rare.

The results have been encouraging: 39 of the 50 patients have lived more than 5 years, while 22 of the 43 patients who have been followed for a minimum of 10 years are living and well.

The breakdown of the 10 year follow-up group shows that 9 patients were classified as Stage I, 29 as Stage II, and 5 as Stage III, although all patients had more advanced disease than had been clinically anticipated and the surgical procedure alone was not able to take care of the disease.

The 5 year survival in this patient group following combined surgical and radiotherapeutic management is 76 per cent and the 10 year survival is 50 per cent, which represents a significant achievement without a mutilating operation and without serious complications following the combined therapy.

Despite the fact that it is difficult to prove the value of the method statistically, I do believe that the combined method can be highly recommended and ought to be used whenever a radical hysterectomy has proved to be an insufficient procedure.

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