ABSTRACT
The development of the method of complex radiation treatment at the Institute in 1946-1980 is followed. Clinical data on 2,313 patients with stage I, II and III carcinoma of the uterine cervix formed the basis of a multifactor analysis. Five-year survival rates and frequency of complications following different modalities of radiation therapy were studied. The 5-year survival rate in cases of orthovolt X-ray therapy or intracavitary gammatherapy from unfixed sources was 54.2% (all stages of carcinoma). The results were improved by 11.9% (66.3% versus 54.2%) when remote gammatherapy using increased focal doses in the zones of parametral and lymphogenic metastatic spread was employed and the exposed volume and the focus of lesion were properly aligned. The development of pretreatment X-ray topometric procedures was followed by a further improvement in the results (72.2% as compared with 60.7%), particularly in cases of stage III carcinoma. The 5-year survival rate rose to 80.1% (all stages) as a result of application of complex radiation therapy preceded by suitable topometric preparation.
Subject(s)
Uterine Cervical Neoplasms/radiotherapy , Brachytherapy , Combined Modality Therapy , Cystitis/etiology , Female , Follow-Up Studies , Humans , Proctitis/etiology , Radiation Injuries/etiology , Radiotherapy Dosage , Radiotherapy, High-Energy , Uterine Cervical Neoplasms/mortalityABSTRACT
The many-year experience with the treatment of cervical cancer in the gynecological clinic of the P. A. Herzen Research Institute of Oncology has indicated that a combined method in case of the appropriate indications provides for high and persistant late results. The five-year recovery of patients at all stages was noted in 78.7% (I stage--87.3%; II stage--71.6%; III stage--41.7%). Improvement of therapeutic and diagnostic methods, strict adherence to the principles of a differential approach to selecting the type of therapy enabled increasing the per cent of a five-year cure from 68.9%' (1945--46) to 91.8% in 1965--1969. The clinical features of microinvasive cervical cancer (stage Ia) made it possible to reduce the extent of the treatment applied on account of excluding a radiation component and lessening the extent of surgical intervention. A five-year cure by the surgical method in patients with cervical cancer of stage Ia made up 97%. The results of the combination therapy in patients with stage Ib within the same period yielded 94%.
