Five hundred and fifty patients treated for carcinoma of the uterine cervix at the Department of Therapeutic Radiology, Seoul National University Hospital from 1979 to 1986, were analyzed retroepectively for late rectal complications. Of them, 468 patients received primary radiotherapy for the cervix cancer in intact uterus, and the other eighty two patients were treated postoperatively. The cumulative incidence of radiation induced rectal complication of grade 2 or 3 was 6.7% at five years. The mean rectal dose for the group of patients with complication was higher than the group without complication, and the difference was statistically significant (p< 0.01). But relationship between mean rectal dose and severity of complication was not found. The frequency of complication (grade 1, 2, 3) increased as a function of radiation dose to rectum; from 16.1% for patients with rectal dose less than 6,000 cGy to 71.2% for patients with rectal dose higher than 8,000 cGy. Among various factors analyzed, history of diabetes mellitus, number of intracavitary irradiation, size of ovoid, retroflexion of uterus and the total dose delivered to rectum turned out to have significant effect on the complication.
Cervix Uteri* ; Diabetes Mellitus ; Female ; Humans ; Incidence ; Radiation Oncology ; Radiotherapy ; Rectum ; Seoul ; Uterine Cervical Neoplasms ; Uterus

Experiments have been carried out with C3H mouse fibrosarcoma (FSa II) to determine the effect of different sequence and time intervals between irradiation and administration of cis-diamminedichloroplatinum(cia-DDP) with gross tumors (6 mm in diameter), microscopic tumors (3 days after transplantation of 103 cells) and cells in culture. The drug was administered either 24, 12, 8, 4, 2, 1, 0.5 hour before irradiation, immediately before irradiation, or 0.5, 1, 2, 4, 8, 12, 24 hours after irradiation. In case of in vivo studies, tumor growth delay was used as an end point. Clonogenic cell surviving fraction was used for in vivo studies. Tumor growth delay for gross tumor after 10 Gy radiation plus 10 mg/kg cis-DDP ranged from 0.3 to 10.66 days and the enhancement ratio ranged from 1.37 to 2.23. The most effective combination was whets cis-DDP was given 4 hours before irradiation. Tumor growth delay for microscopic tumor after 5 Gy of radiation and 5 mg/kg of cia-DDP ranged from 3.55 to 11.98 days with enhancement ratio from 2.05 to 6.92. Microscopic tumors showed response significantly greater than additive in every time interval and the most effective treatments were when cis-DDP was given 2 and 1 hour before irradiation. In in vitro experiment, the surviving fraction after 6 Gy of radiation and 1 hour exposure to 4 mu cia-DDP fluctuated as a function of time between treatments, but the difference between maximum and minimum surviving fractions was very small. According to the above results the sequence and time interval between irradiation and chemotherapy is very critical especially for the management of microscopic tumors as in the case of postoperative adiuvant treatment.
Animals ; Cisplatin* ; Drug Therapy ; Fibrosarcoma* ; Mice ; Mice, Inbred C3H* ; Radiation Dosage