The treatment of early cancer of the corpus uteri

This paper analyses the results of post-operative radiotherapy in 256 cases of cancer of the corpus uteri. Myometrial invasion by tumour was shown to be significantly related to histological grading (p less than 0.001) as it was to recurrence rates (p less than 0.025). By placing patients into one of three subsets according to the depth of myometrial invasion, survival was sufficiently different for each subset to validate their use, not only for prognostic purposes but to determine the type of radiotherapy indicated. Radiotherapy was given as either local intravaginal treatment using an obturator loaded with 60Co or by a combination of this and external beam teletherapy. The value of using radiotherapy to treat the whole pelvis as opposed to treating only the vaginal tissues was significant (p less than 0.01) in terms of local disease control for the deep myometrial invasive group. In terms of survival, external beam therapy was of benefit for all three subsets, i.e. superficial, not more than half and more than half myometrial invasion. A planned approach to post-operative radiotherapy was significantly better for the series as a whole compared to previous ad hoc approaches (p less than 0.01). The treatment methods used did not produce unacceptable morbidity.