From 1958 to 1970, in 435 cases (60%) out of 725 carcinomas of the uterus sole radiation therapy by cobalt-60 beads was performed; in 288 cases (39.7%) surgery was done (combined with tele-cobalt-irradiation in almost all cases, 5000 to 6000 rd TD). Two cases (0.3%) received no treatment. The unfavorable selection of the irradiated women (average age 64,6 years) as against the surgically treated ones (average age 50.9 years) did allow a complete intracavitary irradiation only in 60.6% of the cases; in 39.4%, the dose had to be reduced considerably. The five-year survival amounted to: 64.4% after sole irradiation, 93.2% after operation/postirradiation in stage I; 46.9% after sole irradiation, 75.0% after operation/postirradiation in stage II; 30.8% after sole irradiation in stage III. No survivors existed in stage IV. Mortality from treatment with sole irradiation amounted to 1.8% (8/435). Radiation fistulas were observed after sole irradiation in 0.4% (1/435), after operation/postirradiation in 0.7% (2/288). As long as there is no satisfactory afterloading technique for intracavitary irradiation of the carcinoma of the uterus, an application of cobalt-60 beads seems to offer the following advantages as compared to an implant of radium filters: Shorter duration of the application, better adaptability to the cavitary lumen, diminished risk of perforation. No perforation was observed.
Adult Aged