Complications following radiotherapy in gynaecological carcinoma. Comparison between X-ray and megavoltage therapy
Punnonen, R.; Grönroos, M.; Rauramo, L.; Voutilainen, A.; Aho, A.J.; Hartikainen, P.
Annales Chirurgiae et Gynaecologiae 65(1): 62-67
1976
ISSN/ISBN: 0355-9521 PMID: 829842 Document Number: 109129
The use of megavoltage therapy was shown to be associated with improvement in the prognosis of gynecological carcinoma. The present purpose was to clarify whether the character or number of complications has changed with the increased effectiveness of treatment. From 1967-1970, 449 cases of gynecological carcinoma (cervical, endometrial, ovarian) were treated. Telecobalt was used for external radiation. The comparison period was 1963-1965 when 289 patients were treated, the external radiation then in use being X-ray therapy. Intracavitary radiation was given in both groups using the modified Stockholm method for cervical carcinoma and the Heyman method for endometrial carcinoma. Operative activity was about the same in both periods. Patients with cervical carcinoma treated wit telecobalt appeared to have a higher frequency of severe intestinal complications (12.4%) than patients receiving X-ray therapy (6.0%); the difference was not statistically significant. The same is true concerning the treatment groups of ovarian cancer (4.8% and 0%, respectively) and those of endometrial carcinoma (5.2% and 1.2%). If all patients as a group are considered and also those with urological complications, the difference was significant (P < 0.05), the frequency of complications being 7.6% for patients treated with telecobalt and 4.2% for those treated with X-ray therapy. One must take into account that in all cases the most difficult complications were seen in patients treated with telecobalt, where surgical treatment was necessary in 29%.