Radiotherapy and Fistula Formation in Cervical Carcinoma.*

The Complications of Radium Therapy in Cancer of the Uterine Cervix*

“…Three hundred and fifty cases have now been followed for a minimum period of 5 years or to previous death; and in this group there were 20 rectal, 13 vesical and 6 recto-vesico-vaginal fistulae, a fistula-incidence of 11 per cent. As Graves ei alial" point out, many of the published figures are too low, and being based on recently treated cases, give a totally erroneous view of the frequency of this complication.…”

“…Some of these patients had been recently irradiated and it was recognized that in many of the living group the disease was still active and the percentage of fistulae would inevitably increase. Three hundred and fifty cases have now been followed for a minimum period of 5 years or to previous death; and in this group there were 20 rectal, 13 vesical and 6 recto-vesico-vaginal fistulae, a fistula-incidence of 11 per cent. The fistulae all occurred in the presence of active disease at an average interval of 10 months after the first, and 7 months after the last irradiation, and 80 per cent appeared within 3 years of initial treatment, which is significant when the value of a 3-year follow-up is considered.…”