3D-Image-Guided Multi-Catheter Interstitial Brachytherapy for Bulky and High-Risk Stage IIB–IVB Cervical Cancer

Abstract

This study aimed to evaluate the efficacy and safety of computed tomography-magnetic resonance imaging (CT-MRI)-guided multi-catheter interstitial brachytherapy for patients with bulky (≥4 cm) and high-risk, stage IIB–IVB advanced cervical cancer. Eighteen patients who underwent concurrent chemoradiotherapy with multi-catheter interstitial brachytherapy between September 2014 and August 2020 were enrolled. The prescribed dose of external beam radiotherapy was 45–50.4 Gy, and the brachytherapy high-dose-rate aim was 25–30 Gy per 5 fractions. The endpoints were four-year local and pelvic control rates, four-year disease-free and overall survival rates, and the adverse events rate. The median follow-up period was 48.4 months (9.1–87.5 months). Fifteen patients received concurrent cisplatin therapy (40 mg/m2, q1week). Four (22.2%), seven (38.9%), and seven (38.9%) patients had stage II, III, and IV cervical cancer, respectively. Pelvic and para-aortic lymph node metastases were observed in 11 (61.1%) and 2 (11.1%) patients, respectively. The median pre-treatment volume was 87.5 cm3. The four-year local control, pelvic control, disease-free survival, and overall survival rates were 100%, 100%, 81.6%, and 87.8%, respectively. Three (16.7%) patients experienced grade 3 adverse events, and none experienced grade 4–5 adverse events. CT-MRI-guided multi-catheter interstitial brachytherapy could be a promising treatment strategy for locally advanced cervical cancer.

Observation of hemostatic effectiveness and safety of ultrasound-CT guided 3D intracavitary and interstitial brachytherapy in the treatment of larger cervical cancer with bleeding: A retrospective study

“…and overall survival at 4 years were 100%, 100%, 81.6%, and 87.8%, respectively. [23] According to the advantages of 3D-IGBT in the past, patients with cervical cancer who had tumors larger than 4 cm, and who had clinical bleeding volume >100 mL that resulted in anemia affecting treatment decisions, or who converted to palliative treatment, were selected for 3D-IGBT hemostasis treatment. [24] The reason for the vaginal bleeding caused by the rupture of newly formed capillaries due to tumor proliferation also became an indication for IGBT.…”

“…Stage II, III, and IV cervical cancer were identified in 4 (22.2%), 7 (38.9%), and 7 (38.9%) women, respectively. [ 23 ] The percentages of disease-free survival, pelvic control, LC, and overall survival at 4 years were 100%, 100%, 81.6%, and 87.8%, respectively. [ 23 ]…”

“…[ 23 ] The percentages of disease-free survival, pelvic control, LC, and overall survival at 4 years were 100%, 100%, 81.6%, and 87.8%, respectively. [ 23 ]…”

Clinical research of the value of high-risk CTV setting on intensity-modulated radiotherapy for stage IIB-IVA cervical cancer

“…It can increase the dose of the cancerous area while decreasing the dose of nearby OARs [ 29 ]. In a study evaluating the efficacy of IB for patients with bulky (≥ 4 cm) and high-risk, stage IIB-IVB advanced cervical cancer, the four-year rates of local control, pelvic control, DFS, and OS were 100%, 100%, 81.6%, and 87.8%, respectively [ 30 ]. Although IB is a viable medical procedure, it should be noted that it is invasive and carries a significant risk of complications, including but not limited to infection and haemorrhage.…”

A Retrospective Study of Chemotherapy and 3D-Image-Guided Afterloading Intracavitary Radiotherapy in Locally Advanced Cervical Cancer

“…It improves the effect of treatment and quality of life of patients effectively [22]. Nevertheless, there are few studies on whether there is a difference in the efficacy between combination therapy and neoadjuvant chemotherapy alone in LACC treatment [23].…”