Therapy for Carcinoma of the Uterine Cervix; Part I: Irradiation

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RECENT enthusiasm for the surgical treatment of carcinoma of the uterine cervix has resulted in a tendency to forget the continuing place of irradiation for cure or for palliation, and sometimes as a complement to surgical therapy. This report presents our current use of irradiation in the treatment of cervical carcinoma. A second communication will present the indications for surgery for this condition.

General Indications for Irradiation

We do not hold to strict rules for the treatment of cervical carcinoma, beyond adhering to the concept of individualization of treatment for each patient. It is as wrong to subject all patients to irradiation as it is to subject all to surgery. The individually appropriate therapy involves consideration of: the extent of the patient’s disease, her general physical condition, her age, her marital status, and the quality of available irradiation or surgical technics.

At present we use irradiation as primary therapy for most of the League of Nations stage I and stage II uterine cervical carcinomas. An additional major indication for irradiation is advanced disease that is not amenable to surgery or to curative radiotherapy. Irradiation is particularly valuable in the control of potentially exsanguinating bleeding and intractable deep pelvic pain.

Pretreatment Evaluation

Uterine cervical carcinoma is more than a gynecologic disease, for it may spread to involve the rectum, the bladder, or the deep pelvic nerves. Thus, the patient may be evaluated by a urologist, a proctologist, an internist, and a neurologist, in addition to the gynecologist and the radiologist. Pretreatment. . .



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