TREATMENT OF CARCINOMA OF THE CERVIX AND ENDOMETRIUM USING THE CATHETRON AT THE MIDDLESEX-HOSPITAL

Since January 1974, the Cathetron, a remote loading device using high activity cobalt-60 sources, has replaced intracavitary radium in the curative and palliative treatment of 199 cases of carcinoma of the uterine body and cervix. Sixty-six patients with carcinoma of the cervix have been followed up for a minimum period of three months following treatment by external irradiation to the whole pelvis (5500 rad tumour dose using 8 MV), plus two to three Cathetron insertions each giving 750 rad to point 'A', at weekly intervals. Forty-six (70%) are alive and disease free 3-38 months after termination of treatment. Of the 12 who developed recurrent disease, only six recurred in the pelvis. The Cathetron was used pre-operatively at weekly intervals giving 1000 rad to point 'A' (see text) on each of four occasions in cases of carcinoma of the endometrium prior to extended or Wertheim hysterectomy four weeks later. Forty per cent showed no residual disease at the time of surgery. Forty-three patients have been followed for a minimum period of six months, of these 33 are alive with no residual disease, eight died of their disease but in five of these spread to pelvic glands of beyond was found at operation. A further 13 patients were treated post-operatively and a further 20 by radiotherapy alone. We have been completely satisfied by these Cathetron treatments which have taken place on one half-day weekly. We have not sustained any mechanical problems. The advantages of the Cathetron include increased accuracy from complete fixation of the sources during treatment, individualisation of treatment with the availability of eight sources and complete staff protection. There were no rectal reactions and only two severe complications to the bladder and rectum. Complications to the sigmoid colon were associated with external radiotherapy. The results reported are early but in regard to local cure the high dose rate given by cobalt-60 sources gave results as good as the best achieved with radium but careful follow-up will be necessary for several years to monitor late effects. There will be further reports every two years. © 1979.