Enteric morbidity of postoperative pelvic external beam and brachytherapy for uterine cancer

From 1970 through 1986, 219 women received postoperative pelvic external beam therapy and vaginal radium or cesium for uterine cancer. Prescribed external beam and total vaginal surface doses ranged from 38 to 51 Gy and from 70 to 119 Gy, respectively. Severe enteric morbidity developed in 7.80% of patients (15 small bowel, 1 sigmoid, 1 rectal). Complications occurred more frequently in patients with pelvic lymph node sampling at hysterectomy, abdominal surgery prior to hysterectomy, and low body weight. Logistic analysis demonstrated no significant effect of pelvic external beam dose, vaginal surface boost dose, or milligram hours. Five and 10-year overall survival rates were 85% and 74%, respectively. There were two proximal and one distal vaginal recurrences. Recommendations for avoiding complications are presented.