Parametrial implant in stage III B cancer of the cervix III. A five‐year study

Abstract

Since 1975, the Department of Radiation Therapy, University of Maryland Hospital initiated a policy of supplementing the dose to the affected parametrium by using radium needles implants in conjunction with a protruding tandem preferably, or Manchester ovoid in the case of absence of the lower segment of the uterus. The authors have noted a remarkable improvement in local control as well as an improved three‐year survival rate with minimal immediate complications. Additional Stage IIIB (FIGO) cases were collected and they were treated by the same technique and have a close follow‐up since 1975. Forty‐nine cases studied, 32 (65%) survived with disease‐free status for a minimum of five years with no loss to follow‐up. Local control was excellent, as expected, at the level of 84% (41/49). There were 8% major complications as a consequence of radiation treatment and the majority of them required surgical intervention with excellent success. Paraaortic metastasis remains a major problem and requires further study. The current plan will include retroperitoneal exploratory laporatomy and para‐aortic node sampling with extension of the external beam portals to include the positive node region and followed by interstitial and intracavitary brachytherapy. Copyright © 1983 American Cancer Society