A STUDY OF ANATOMY AND DOSIMETRY IN THE TREATMENT OF CARCINOMA OF THE UTERUS

Three dimensional dose distribution diagrams for intracavitary radium applications are now generally available. These provide more dose information than the clinician has requested in the past. To take advantage of this development, more comprehensive anatomic demonstrations are advocated as part of each radium application.

Since radiosensitivity of individual cancers cannot be predicted, and since extent cannot be determined, prescription of a cancerocidal dose is not a meaningful approach to treatment.

The crucial factor in successful treatment is the tolerance of normal tissues and organs. These can be identified anatomically and such anatomic studies lend themselves to correlation with the comprehensive dose distribution data provided by computer output.

The proper prescription of dose then becomes its tolerance dose for normal tissue.

Analysis of past experience provides the safe limits of exposure. The combination of three dimensional dose distribution studies, and anatomic demonstrations can reveal sites of inadequate or excessive dose rates that, but for such identification, would lead to unsuspected oven- or underdose levels and unexplained failures of treatment or complication of treatment.

Decision-making in any instance is aided by all pertinent information. With more comprehensive dosimetry and more precise anatomic controls, the clinician can assess his results more closely and guide his future cases more surely.

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