A Comparison of Clinical Results Following High Dose‐Rate Intracavitary Afterloading Irradiation with Co⁶⁰ (Cathetron) and Conventional Radium Therapy for St. I‐II Endometrial Carcinoma

Abstract

Absrruct. From 1970From to 1976,91 patients with St. 1-11 endometrial carcinoma associated with a small uterine cavity (59 cm) were treated with the Cathetron (C) and 125 with radium (R). Surgery was carried out on 59.3 % of the patients in group C and 80.0 % in group R two weeks after the intracavitary radiotherapy and 56.0 % of the patients in group C and 39.2 % in group R received external irradiation with or without an operation. There was no statistical difference in the survival between the two treatment groups, the 5-year crude survival being 79.4 % for group C and 82.4 % for group R, and the 3-year crude survival rates 82.4 YO and 88.0 % respectively. There was no statistically significant difference in the local recurrence of tumour between group C (3.3 YO) and R (0 %); nor were the rates of early complications different, 3.3 % in group C against 4.0 % in group R. No differences were found in operative difficulties or early postoperative morbidity between the two groups during or after hysterectomies and bilateral salpingo-oophorectornies after intracavitary radiotherapy.

Comparison of Heyman packing and Cathetron afterloading methods in the treatment of endometrial cancer

“…Using the Heyman method as the preoperative irradiation the crude survival figures (83.9% in stage I and 42.1% in stage II) were quite similar to those from another Finnish treatment centre, 87.3 and 55.7% (Taina, 1981). After the exclusion of the unoperated cases and the patients who died of intercurrent diseases, our results in stage I (95.9%) and in stage II (74.4%) are remarkably good, and they emphasise the importance of surgery as a principal element in the treatment of clinical stage I and II endometrial carcinoma.…”

“…The afterloading technique has been applied in the treatment of endometrial cancer, mostly for postoperative vaginal irradiation (O'Connell et al, 1980;Cikaric, 1980;Joslin, 1980;Ristic et al, 1980;Snelling et al, 1980) and only in a few centres for intracavitary radiotherapy (Kauppila & Kiviniitty, 1980;Taina, 1981). The follow-up in these latter two studies has covered a relatively short period.…”

“…Heyman's packing method is one of the most commonly used preoperative radiotherapeutic techniques (Heyman, 1929;Heyman et al, 1941). Because of the radiation risk to personnel, the fact that the method is relatively laborious, and the difficulties in accurately determining the distribution of radiation, attempts have been made to replace it by an afterloading high doserate technique, e.g., the Cathetron (Henschke, 1960;Henscke et al, 1966;Martenson et al, 1968;Unnerus & Kiviniitty, 1968;Walstam, 1962Walstam, , 1965Kauppila & Kiviniitty, 1979;Taina, 1981). In our hospital, intracavitary radiotherapy of endometrial cancer has been performed since 1974 using the Cathetron technique, which displaced the Heyman procedure.…”

Complications Following High and Low Dose‐Rate Intracavitary Radiotherapy for St. I‐II Endometrial Carcinoma: A Comparison of Remotely Afterloaded CO60 (Cathetron) and Conventional Radium Therapy

“…The mean C dose was 29.4 f 1.0 Gy at point A and 8.5 f 0.3 Gy at point B. R treatment was given by the Heyman packing method (14, IS) divided into 2 fractions 2 weeks apart, and the mean dose was 47.6 f 1.0 Gy at point A and 12.8 k 0.3 Gy at point B. Fifty-five patients (60.4 %) of group C and 100 (80.0 %) ofgroup R were operated on 2 to 3 weeks after the intracavitary therapy with the exception of 1 patient in group C, who received the intracavitary treatment postoperatively to the vagina. The proportion of patients with external radiotherapy was 56.1 % in group C and 39.2 % in group R by a method described before (40). The mean external doses in group C and and R were 31.9 & 2.2 Gy at pointAand46.9k 1.3GyatpointBand25.5f2.2Gyand…”

Die Bedeutung der Strahlentherapie für die Behandlung des Kollumkarzinoms

“…Auch die sonst bisher in der Literatur mitgeteilten Ergebnisse der intrakavitären high-dose-rate-Brachytherapie lassen keine Unterschiede in den Behandlungsergebnissen zwischen diesem Verfahren und der klas sischen Radiumtherapie erkennen [1,4,5,7,11,12,14].…”