Value of tube combined with real-time ultrasound-guided accurate interstitial high-dose-rate brachytherapy for post-operative pelvic side-wall recurrences of cervical cancer.
| Autor: | Mamady K; Department of Gynecologic Radiotherapy, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.; Surgical Oncology Unit of Donka University Hospital, Conakry, Guinea.; Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China., Chen X; Department of Gynecologic Radiotherapy, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.; Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China., Malick B; Surgical Oncology Unit of Donka University Hospital, Conakry, Guinea., Fang Z; Department of Gynecologic Radiotherapy, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.; Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China., Niu H; Department of Gynecologic Radiotherapy, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.; Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China., Bangaly T; Surgical Oncology Unit of Donka University Hospital, Conakry, Guinea., Liu H; Department of Gynecologic Radiotherapy, The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.; Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance, Shijiazhuang, China. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of contemporary brachytherapy [J Contemp Brachytherapy] 2021 Dec; Vol. 13 (6), pp. 633-640. Date of Electronic Publication: 2021 Dec 30. |
| DOI: | 10.5114/jcb.2021.112114 |
| Abstrakt: | Purpose: Treatment of post-operative pelvic side-wall relapses of cervical cancer has always been a therapeutic challenge for radiation oncologists. Radiation dose boost to recurrent tumor by brachytherapy is necessary, but difficult to achieve. Our treatment center has successfully achieved precise transvaginal insertion of a pelvic side-wall mass, using a metal tube with real-time ultrasound guidance. This study investigates the efficacy and safety of image-guided high-dose-rate (HDR) interstitial brachytherapy (IBT) for patients with post-operative pelvic side-wall relapses. Material and Methods: Between 2018 and 2020, 36 post-operative pelvic side-wall relapses of cervical cancer patients receiving external beam radiotherapy (EBRT) combined with HDR-IBT were analyzed retrospectively. Doses per fraction ranged from 6.0 to 7.0 Gy, whereas cumulative equivalent doses in 2 Gy fractions ranged from 80 to 100 Gy. Effects of prognostic factors on local control (LC) and progression-free survival (PFS) were analyzed, and late toxicity data were evaluated. Results: A total of thirty-six patients were included, with a median follow-up of 19.3 months. The tumor response was obtained for all patients, with radiological complete remission in 20 (55.6%) patients. Two-years LC and PFS rates were 72.2% and 47.2%, respectively. Grade II rectal toxicity was observed in 5 patients (13.9%). Multivariate analyses for LC and PFS using proportional regression model were performed, in which shape of exophytic tumor was associated with a significantly better prognosis for both LC and PFS (HR = 0.071, 0.128, p = 0.005, 0.002). Clinical target volume (CTV) D Conclusions: A metal tube placed in the vagina, under the guidance of real-time ultrasound in transvaginal IBT for pelvis masses can be accurately achieved. The shape of exophytic tumor and CTV D Competing Interests: The authors report no conflict of interest. (Copyright © 2021 Termedia.) |
| Databáze: | MEDLINE |
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