Can treatment of carcinoma of the cervix be individualized?

Assessment of response of cervical cancers to irradiation by the conventional histological method of biopsies done during the course of radiotherapy in 51 Stage I and early stage II patients was discussed. The prediction of response to irradiation was based on the nuclear and cytoplasmic changes in the tumor cells. Two applications of intracavitary radium or external irradiation followed by intracavitary radium were given to the patients. Wertheim hysterectomy was done 4–6 weeks after irradiation in the former and 3–4 weeks after irradiation in the latter. The accuracy of the prediction was correlated with the presence of residual growth in the surgical specimens. The prediction based on biopsies done after intracavitary radium was found to be of significance. If the patient was treated initially by external irradiation, biopsy should only be taken after 5400 rad or on completion of the whole course. Validity of this study was discussed. It was concluded that it is possible to select patients who would respond poorly to irradiation for surgery.