An analysis of the records of 916 patients who received radiotherapy for invasive squamous cell carcinoma of the intact uterine cervix from January 1964 through December 1969 revealed that 94% of the central and regional failures will occur within 3 years of treatment. Survival rates were as follows: Stage I, 91%; Stage IIA, 82%; Stage IIB, 65%; Stage IIIA, 54%; and Stage IIIB, 40%. The incidences of central and regional failures in Stages I through III are: Stages I and IIA; central 2% and regional 4.5%; Stage IIB; central 5% and regional 13%; Stage III: central 14% and regional 19%. In stages IIB, IIIA, and IIIB, the main cause of failures, either centrally or in the parametria, is the presence of massive disease.

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Treatment tolerance and early complications have been analysed in patients treated with extended field irradiation and pelvic irradiation alone. At the Centre Georges-François Leclerc, 126 patients were treated for carcinoma of the uterine cervix and endometrium from May, 1972 to November, 1974. All patients received external irradiation using a 25 MV X-ray beam. Follow-up has been nearly complete in all patients with the minimum follow-up being 15 months and the average 24 months. Treatment tolerance was approximately the same for all field sizes except when the field was extended to the top of D12. In this situation the patients occasionally required a short rest during their irradiation. The age of the patient was found to contribute significantly to the tolerance, with 70% of the patients who experienced poor tolerance being older than 60 years. Complications were evenly distributed in all all catagories of field size and appeared to be affected only by age and previous surgery. Of the patients who experienced complications 68% were older than 60 years, and of the 37 patients who had previous surgery, 32% had a complication. With certain treatment modifications the treatment tolerance and early complications appear acceptable when using extended field irradiation for gynaecological cancer.

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