Abdominal radiotherapy for cancer of the uterine cervix and endometrium

From 1973 through 1985, 49 women received postoperative open-field whole abdominal radiotherapy as primary management for peritoneal metastases from uterine cancer. The 5-year relapse-free rate was 63% in women with endometrial carcinoma, and two prognostic subsets were identified. Five-year relapse-free rates fell from 77% in women with spread to the adnexa or peritoneal fluid to 36% in women with macroscopic spread of cancer beyond the adnexa. Any peritoneal spread of cervical carcinoma yielded a 3-year relapse-free rate of 31%. Although abdominal spread of cervical cancer was associated with other poor prognostic factors, peritoneal metastases frequently occurred in otherwise early endometrial cancer. Four percent of patients developed small bowel obstruction requiring surgical intervention. The utility and limitations of whole abdominal radiation are discussed.