Decrease in uterine perforations with ultrasound image-guided applicator insertion in intracavitary brachytherapy for cervical cancer: A systematic review and meta-analysis

Sapienza, Lucas Gomes; Jhingran, Anuja; Lin, Lisong; Calsavara, Vinícius Fernando; Gomes, Maria José Leite; Baiocchi, Glauco

doi:10.1016/j.ygyno.2018.10.011

Cited by 17 publications

(11 citation statements)

References 29 publications

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“…Real-time guidance with either transabdominal or transrectal ultrasound is easy to obtain and can reduce the risk of uterine perforation. 67 Magnetic resonance imaging (MRI) and computed tomography (CT) are standard for brachytherapy treatment planning. MRI, however, provides superior soft tissue definition, making it easier to visualize the cervix and residual disease compared with CT imaging.…”

Section: Conditional Lowmentioning

confidence: 99%

Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline

Chino

Annunziata

Beriwal

et al. 2020

Practical Radiation Oncology

181

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Sources of support: This work was funded by the American Society for Radiation Oncology. Task Force Members' Disclosure Statements All task force members' disclosure statements were rigorously reviewed before being invited and were shared with other task force members throughout the guideline's development. Those disclosure are published within this report. Where potential conflicts were detected, remedial measures to address them were taken.

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Section: Conditional Lowmentioning

confidence: 99%

Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline

Chino

Annunziata

Beriwal

et al. 2020

Practical Radiation Oncology

181

View full text Add to dashboard Cite

show abstract

“…This study was consistent with those studies and specifically demonstrates that US has high accuracy for judging the positions of implant needles and the relationship with surrounding organs in parametrial brachytherapy for cervical cancer. Hence, it can guide the distribution and depth of implant needles, reduce injury to normal tissues, and have a positive effect on real‐time monitoring of parametrial brachytherapy for cervical cancer …”

Section: Discussionmentioning

confidence: 99%

Clinical Application of Ultrasound Guidance for Parametrial Treatment of Advanced Cervical Cancer

Lin

Cheng

Shi

et al. 2019

J of Ultrasound Medicine

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Objectives-To evaluate the accuracy of ultrasound (US) in determining the positions of parametrial implants by comparing US with magnetic resonance imaging (MRI) for advanced cervical cancer.Methods-Patients undergoing brachytherapy with parametrial implantation for cervical cancer from February 2017 to February 2019 were involved in the study. The transverse section of the cervix (surface S 1 ) and the transverse section 1 cm above the external cervix (surface S 2 ) were selected from MRI and US images as the observation planes. In the MRI observation plane, the distances between the uterine titanium needles and the uterine tube/implanter were set as M 1 to M 4 ; in the US observation plane, the distances between the uterine titanium needles and the uterine tube/implanter were set as D 1 to D 4 . The differences and consistency in M and D of each group were then compared.Results-There were no significant differences between M and D in each group (P = .058; P = .821; P = .870; and P = .936, respectively). The intraclass correlation coefficients of M and D in each group were 0.970, 0.968, 0.952, and 0.956. A regression analysis showed that the relationships between M and D in each group were as follows: M 1 = 0.9449D 1 + 0.1812; M 2 = 0.9463D 2 + 0.0965; M 3 = 0.9176D 3 + 0.1233; and M 4 = 0.9253D 4 + 0.1224.Conclusions-In parametrial brachytherapy for cervical cancer, US can accurately determine the positions of parametrial implantation needles, which is already applicable on MRI, and can provide assistance in parametrial brachytherapy for advanced cervical cancer.

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“…In the present study, the rate of uterine perforation was 1.2% (5/407). In a related study, Sapienza et al (28) found that the ratio of perforations in the un-guided/guided groups was 9.94 per insertion. Moreover, Onal et al (29) suggested that MRI images taken before brachytherapy could effectively reduce the risk of uterine perforation.…”

Section: Operation-related Side Effectsmentioning

confidence: 92%

Analysis of Applicator Insertion Related Acute Side Effects for Cervical Cancer Treated With Brachytherapy

et al. 2021

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PurposeTo report applicator insertion-related acute side effects during brachytherapy (BT) procedure for cervical cancer patients.Materials and MethodsBetween November 2017 and December 2019, 407 BT fractions were performed in 125 patients with locally advanced cervical cancer. Acute side effects recorded comprised anesthesia-related side effects, mechanical-related side effects and infection, whose frequency and degree were recorded. Pain was assessed using numeric rating scale; vaginal bleeding volume was counted by weighing gauze pieces used in packing. The BT procedure comprised eight stages: anesthesia, applicator insertion, image acquisition, transport, waiting for treatment, dose delivery, applicator removal, and removed which denoted 0.5–12.0 h period after removal, with time of each stage recorded. Factors influencing acute side effects were assessed by Spearman correlation and Mann–Whitney U test.ResultsThe most common acute side effect was pain, followed by vaginal bleeding. The mean scores for pain were highest during removal time, 4.9 ± 1.6 points. The mean vaginal bleeding volume was 44.4 ml during removal time. Mean total procedure time was 218.8 (175–336) min, having positive relationship with frequency of acute side effects. The total procedure time with acute side effects was longer than that without acute side effects. The longest procedure time was waiting time, 113.0 (91.0–132.0) min. More needles generated higher pain scores and larger volume of vaginal bleeding.ConclusionPain and vaginal bleeding were the most common acute side effects, especially during removal time, which physicians should focus on. Shortening patients’ waiting time helps to reduce the total procedure time, thus, reduce acute side effects. While meeting dose requirement, less needles are helpful to reduce acute side effects.

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Decrease in uterine perforations with ultrasound image-guided applicator insertion in intracavitary brachytherapy for cervical cancer: A systematic review and meta-analysis

Cited by 17 publications

References 29 publications

Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline

Radiation Therapy for Cervical Cancer: Executive Summary of an ASTRO Clinical Practice Guideline

Clinical Application of Ultrasound Guidance for Parametrial Treatment of Advanced Cervical Cancer

Analysis of Applicator Insertion Related Acute Side Effects for Cervical Cancer Treated With Brachytherapy

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