An analysis of the severe complications of irradiation of carcinoma of the uterine cervix: treatment with intracavitary radium and parametrial irradiation

Between January 1967 and December 1974, 254 patients with carcinoma of the uterine cervix were treated with either intracavitary radium and parametrial irradiation or 2000 rad whole pelvis irradiation followed by intracavitary radium and parametrial irradiation. In general, these patients had tumors of relatively limited volume and vaginal and uterine anatomy that was favorable for intracavitary radium. Not all patients had a lymphangiogram performed prior to irradiation. Of those who did, only patients with negative lymphangiograms are included in this analysis. All patient had a minimum follow-up of four years. The absolute four year survival rate for this group of patients was 86%. Only 6.3% of patients died of disease. The incidence of severe complications was 7.5%. Complications were associated with a high number of milligram hours of radium plus a high dose of external irradiation, in combination with either asymmetry of the radium system and/or history of previous pelvic inflammatory disease, pelvic surgery, or diverticulosis.     

Radiation therapy in the treatment of aggressive fibromatoses

Twelve patients with aggressive but histologically benign connective tissue tumors (nine desmoids and three neurofibromas) were treated with either radiation or radiation plus surgery. Long term local control was accomplished in eight of nine desmoid tumors and 2 of 3 neurofibromas. In the successfully treated patients, local control was obtained with minimal long term complications when compared with radical surgical procedures that would have been necessary for cure. Details of radiation treatment are discussed along with proposed indications for therapy.     

Patterns of intra-abdominal relapse (IAR) in patients with Wilms' tumor who received radiation: analysis by histopathology. A report of National Wilms' Tumor Studies 1 and 2 (NWTS-1 & 2)

336 non-metastatic patients who received radiation in National Wilms' Tumor Study-1 and 2 have been reviewed. Follow-up was minimum of two years. 15/273 (6%) of the favorable histology patients had intra-abdominal relapse as compared to $\text{8}\text{44}$ unfavorable histology (18%) (P = 0.003). Developing intra-abdominal relapse does not seem related to low radiation therapy doses or small volumes. However, a delay of greater than ten days to start radiation therapy from nephrectomy was related to the occurrence of intra-abdominal relapse in unfavorable histology patients (P < 0.001).