Uterine cervical cancer: treatment with megavoltage radiation results and afterloading intracavitary techniques

Results were evaluated for 651 consecutive patients with invasive cancer of the intact uterine cervix. From 1963 through 1967 319 patients were treated primarily with the older Los Angeles County Hospital system of orthovoltage radiation and intracavitary radium therapy. Thereafter, 1968--1974, 332 patients were treated primarily with a newer modified M. D. Anderson Tumor Institute system of megavoltage radiation and afterloading intracavitary radium therapy. Age distribution and histology were similar for both groups, but clinical stage was slightly more advanced for patients treated earlier. Crude and net 5 year survival rates were 36% and 49% for the early group and 54% and 67% for the later group. Net 5 year survival rates for the earlier group by stage were: stage I, 74%; II, 62%; III, 23%; and IV, 6%. Survival rates for the later group were: I, 81%; II 76%; III, 50%; and IV, 15%. We believe this improvement can be attributed to more effective intracavitary radium therapy for handling local cancer and to delivery of cancericidal doses of radiation to regional nodes with the megavoltage radiation apparatus, as well as to the greater cooperative efforts put forth in the management of County Hospital patients.