The Treatment of Carcinoma of the Cervix Uteri, Stages I and II, with Radium and 4 MeV Supplementary X Rays

Abstract

The development of a method of treatment of carcinoma of the cervix, stages I and II, is discussed, the resulting technique la described and clinical impressions based on the 1st 2 yr. of use are presented. Ra treatment is given by a modified Manchester method. For the supplementary 4 MeV X-ray treatment, parallel opposed 14 x 14 cm diamond-shaped fields are used. This shape of field allows the inclusion of the parametria and the pelvic lymphatic drainage in a smaller volume than does the usual rectangular field. A shaped wedge, whose position is adjusted to cover the region already treated by Ra, is used. The wedge is designed to give combined Ra and X-ray doses of the required distribution throughout the pelvis, to avoid serious under- or over-dosage due to possible errors in matching wedge position to Ra position and partially to shield the region already treated by Ra. isodose distributions in 2 planes for the central and 1 plane for an off-center position of the Ra and wedge are given.