[Comparative morphological studies of cervix cancer and adjacent tissue following preoperative intracavitary contact...

The effects of Cf-252 and Co-60 radiation have been compared by investigating radiation response and radiation pathomorphosis of the cervical carcinoma and surrounding normal tissue. The effectiveness of radiotherapy treatment was evaluated by comparison of Cf-252 and Co-60 irradiated patients (each arm 18 patients) with a non-irradiated control group (15 patients), suffering from epithelium carcinomas of the cervix uteri. The total dose in point A was 60 isoGy in either case given in 3 fractions at 28 days using the after-loading units "ANET" (neutrons) and "AGAT V" (gamma). Two to three weeks after irradiation, extended extirpation of the uterus and its adnexa was performed. The therapeutic effect was strongest in both comparative groups with superficially located exophytic forms of the cervical carcinoma and with carcinoma in situ. With invasive growth forms, signs of therapeutic pathomorphosis were found in both groups predominantly in the superficial tumor areas. However, the extent of the remaining tumor complexes was much greater with Co-60 than with Cf-252 radiation. Adenocarcinomas were more sensitive to Cf-252 independently of the invasion depth of the tumor. The observed alterations in the surrounding normal tissue of the uterus, both in the immediate proximity of the Cf-252 source (endometrium) and at some distance (myometrium, perimetrium) reflect the more severe alterations following irradiation as compared with Co-60. The lower values of the volume density of the tumor parenchyma remaining after radiotherapy and the high damage index (95.5%) give evidence for the pronounced biological and therapeutic effectiveness of high dose rate Cf-252-radiation. They allow to expect improvement of late results in the treatment of patients with epithelium carcinoma of the cervix uteri, and it seems to be reasonable to make further studies in that direction.