Effect of radiation on metastatic pelvic lymph node involvement in carcinoma of the cervix

Abstract

This series of 24 cases is not large enough to permit any final conclusions, but the detailed study of these cases seems to throw considerable light on the problem of irradiation therapy of carcinoma of the cervix.Many advantages have accrued from this project which is still continuing; one of the most significant has been the improved understanding of the treatment (both surgical and radiological) of cancer of the cervix by the house staff of both departments. Also, a greatly enhanced mutual respect has been developed between radiologists and gynecologists as they plan together the treatment for an individual patient.The following statements seem justified from this study: 1.1. Five thousand to 6,000 “tissue roentgens” seems to be the minimal concentration of radiation that will eradicate carcinoma in the pelvic lymph nodes in radiosensitive tumors, when delivered in 5 to 6 weeks.2.2. By the integration of all avenues and modalities of radiation therapy, a minimum of 5,000 to 6,000 r. can be delivered to all areas of the deep pelvis with apparently minimal risk to normal viscera.3.3. Certain tumors have been shown to be radioresistant even with 2 to 3 times the usual cancerocidal dose of roentgens; 20,000 r. failed to eradicate the tumor in one instance.4.4. If surgery is employed postradiation, it should be done relatively early (2 to 3 months) before collateral circulation is seriously compromised.