Biological Factors Influencing the Radiotherapeutic Results in Carcinoma of the Cervix

Abstract

A study of 820 cases of cancer of the cervix treated by radiotherapy in Sheffield between 1945 and 1953 shows a correlation between an increase in clinical stage of the disease and (1) increasing age of the patient, (2) increasing duration of clinical history, (3) increasing anaplasia of the histological tumour type, and (4) increasing Broders' grade of the carcinoma. The local radiocurability of the tumour decreases with increasing stage of the disease and, for the same clinical stage, with increasing anaplasia and Broders' grade of the tumour, but it increases with increasing duration of clinical history. The better differentiated and more slowly growing tumours are more amenable to radiotherapy than the anaplastic and quickly growing tumours. For the same clinical stage the radiocurability is independent of the age of the patient. Failure of radiotherapy in the more advanced stages of the disease is due to persistence of untreated or insufficiently treated distant deposits and to persistence of cancer at the fully treated primary site. The clinical material was found to vary significantly over the period of eight years in respect of clinical stage, age of the patients and incidence of tumour type. To allow for biological variations in the clinical material, samples of at least 400 cases each are needed for a valid comparison of variations in treatment technique.