Early experiences in the treatment of carcinoma of the uterine cervix with cobalt60 teletherapy and intracavitary radium

Abstract

Our preliminary experience with cobalt60 teletherapy in the management of patients with primary carcinoma of the cervix uteri has been based upon theories of optimal dosage obtained from previous studies. We have found that we were able to reproduce the desired levels of dosage in the parametrium by the techniques employed. The early results of treatment indicate that the basic theories seem to hold for the treatment of patients with less advanced lesions. The upper limits of what we considered optimal dose levels may not be so important in the management of patients with far-advanced lesions. The lack of severe complications of treatment at the dosage levels employed indicates that doses may well be increased with safety.Comparative studies of results in patients treated with the cobalt60 unit and those treated with the 450 kv. x-ray apparatus show a slight superiority for those in the cobalt60 series. This superiority seems to be related to a more uniform distribution of radiation throughout the parametrium. Modifications in treatment plan based upon these findings are suggested. These include only moderate increase in parametrial dose by means of external radiation for the early cases, and an appreciable increase in parametrial dose by means of external radiation with moderate limitation of the intracavitary dose from the intracavitary radiation for the advanced cases.