Comparison of Heyman packing and Cathetron afterloading methods in the treatment of endometrial cancer

The five-year survival and the complication rate were evaluated in 307 patients with endometrial carcinoma treated from 1966 to 1977. The distribution of the patients into clinical stages I, II, III and IV was 68.7, 20.8, 6.5 and 3.9%, respectively. In stage I 87.2% and in stage II 67.2% of the patients were operated on. All patients received oral medroxyprogesterone acetate for two years, and all patients with stage I or II disease were also irradiated, mostly intracavitary before operation. The crude 5-year survival in the total material was 72.0%, and for clinical stages I, II, III and IV 83.8, 54.7, 40.0 and 8.3%, respectively. 167 patients in stage I received intracavitary irradiation, 86 using the Heyman packing method and 81 using the Cathetron after-loading technique. The corresponding figures for 54 patients in stage II were 38 and 16. In clinical stage I the crude (83.9% and 84.2%, respectively) and corrected (92.9 and 88.9%, respectively) 5-year survivals were similar in the Heyman and Cathetron groups. In stage II better results were obtained using the Cathetron technique (crude 75.0 vs. 42.1%) but in the corrected material, excluding the unoperated cases, there was no significant difference (81.3 vs. 74.4%, respectively). Serious late complications requiring surgical correction were less common in the Cathetron group (2.9% vs. 11.1%; p less than 0.05). The intracavitary irradiation of endometrial carcinoma can thus be well accomplished by remote afterloading technique.