| Abstract: | In an attempt to improve the therapeutic scheme in cervical carcinoma a clinical research program involving 100 patients with stages 1 and 2 of cervical carcinoma was started. All patients underwent radiation treatment only. In the series 32 patients were state 1 and 68 stage 2. About 1/2 had undifferentiated squamous epithelioma and the others moderately differentiated epthelioma. Radiotherapy consisted of intracavity radium of 5000 mg-hr. and an external telecobalt irradiation up to 4000 rad tumor dose through 4 portals. During and after radiotherapy patients were followed by clinical examiniations and vaginal smears. Months after beginning of treatment another cervical punch biopsy was done. The 3 year recovery rate was 97% of stage 1 but only 75% of stage 2 patients. Recovery seemed better in well differentiated epithelioma and in cases treated first with external radiation. There were 13 deaths from recurrent disease within 5 to 35 months after begining of treatment. Punch biopsies performed 4 months after beginning of treatment revealed carcinomatous tissue in the cervical area of only 2 of these 13 patients. In all 87 survivors, abnormal cells disappeared from vaginal smears by 7 weeks. In the 13 fatal cases, abnormal cells persisted for 7 weeks or beyond. In 5 of the 13 fatal cases, tumor cells in the vaginal smears persisted throughout the remainder of the patients' lives. Other follow-up methods seemed inefficient cases. Well defined vaginal cytology seemed of most prognostic value. The radioresistent group could be submitted to complementary surgical treatment to improve the prognosis. |
