Yasuhiro Kawamura

Treatment of carcinoma of the uterine cervix by remotely controlled afterloading intracavitary radiotherapy with high-dose rate: a comparative study with a low-dose rate system

From September, 1974 through December, 1979, a total of 249 patients with carcinoma of the cervix uteri Stage IIb and III were randomly allocated to either remotely controlled high-dose-rate intracavitary radiotherapy or manual afterloading low-dose-rate therapy, with radiotherapy of 20 Gy in 2 weeks to Point A to whole pelvis and 40 Gy in 4 weeks to the parametria. The dose to Point A by intracavitary radiotherapy was 40-60 Gy with one or two fractions in the low-dose-rate group and 30 Gy for the high-dose-rate group by 3 fractions with a once a week schedule. The purpose of this paper is to compare the results between the groups and to clarify the problems in the high-dose-rate group clinically. The local control rate was higher in the high-dose-rate group; however, the complication rate was also higher in this group than in the low-dose-rate group. The dose schedule and the place of rectal dose measurement is discussed. The overall cumulative survival rate was nearly the same in both groups (55% at 5 years), although some difference was noted in each stage. The most common cause of death was distant metastasis outside the pelvis and the second most common was intercurrent disease in Stage IIb and local failure in Stage III.

Plasma Luteinizing Hormone-Releasing Hormone Levels in Normal Women and Patients with Amenorrhea

Plasma levels of immunoreactive luteinizing hormone-releasing hormone (LH-RH) in 89 women with normal menstrual cycles and 109 patients with amenorrhea of various etiologies were determined by specific radioimmunoassay after methanol extraction. The LH-RH levels in patients with hypergonadotropism and Sheehans syndrome were more than 10 pg/ml, and were significantly higher than basal levels during normal cycles (4.2 +/- 0.3 pg/ml). The mean levels of LH-RH were low in all hypogonadotropic patients with amenorrhea, with the exception of a few patients who showed high LH-RH levels suggestive of a pituitary lesion. The LH-RH levels in patients with polycystic ovary syndrome were comparable with basal levels during normal cycles. It is concluded that, although there is considerable overlap of the plasma LH-RH levels in each group of amenorrheic patients divided according to gonadotropin level, determination of LH-RH levels may be useful for the differentiation of hypothalamic amenorrhea from pituitary amenorrhea.