Rectosigmoid complications of radiotherapy in stage 3B carcinoma of the cervix

A retrospective analysis of 165 patients with Stage 3 B carcinoma of the cervix treated with radiotherapy alone was done; 120 patients were treated with a combination of external radiotherapy and intracavitary treatment while 45 patients received external radiotherapy only. Early rectosigmoid reactions were seen in 65% of cases with Grade 1, 2 and 3 reactions in 40%, 20% and 5% of cases respectively. Late rectosigmoid sequelae were observed in 25 patients (16%) with moderate complications in 5%. Severe rectal complications were seen in 2 women only. Rectosigmoid complications are the most common sequelae of pelvic irradiation and seen more in advanced stages where a greater dose is given by external radiotherapy. The role of rectal dosimetry is equivocal if proper precautions are taken during intracavitary treatment.