Clinical outcome of combined intracavitary/interstitial brachytherapy using a hybrid applicator in locally advanced cervical cancer

Rogowski, Paul; Rottler, Maya; Walter, Franziska; Saicic, Stefan; Niyazi, Maximilian; Well, Justus; Nierer, Lukas; Trillsch, Fabian; Burges, Alexander; Mahner, Sven; Belka, Claus und Corradini, Stefanie (2022): Clinical outcome of combined intracavitary/interstitial brachytherapy using a hybrid applicator in locally advanced cervical cancer. In: Gynecologic Oncology, Bd. 166, Nr. 3: S. 576-581

Abstract

Objective. The aim of this study was to evaluate the clinical outcome in locally advanced cervical cancer (LACC) after image-guided adaptive brachytherapy (IGABT) with combined intracavitary and interstitial (IC/ IS) techniques using the hybrid Venezia applicator (Elekta AB, Sweden).Methods. LACC patients (UICC Stage IIB - IVB) treated with radiochemotherapy followed by IGABT with the hybrid IC/IS Venezia applicator at a single institution were retrospectively analyzed. Treatment comprised EBRT of the pelvis with 45 Gy and concomitant weekly cisplatin chemotherapy (40 mg/m2) followed by MRI-based IGABT. Dosimetry, oncological outcome and toxicity were investigated. Results. Forty-six patients underwent a total of 184 fractions of IGABT between 2017 and 2020. Median follow-up was 24 months. Combined IC/IS techniques were used in 40 patients (87%). The median HRCTV vol-ume was 31.2 cm3 and the median HRCTV D90% was 92.3 Gy (EQD210). The median D2cm3 was 74.8 Gy for bladder, 57.9 Gy for rectum, 60.0 Gy for sigmoid and 52.2 Gy for bowel (EQD23). The 3-yr actuarial rates were 97.6% for local control, 97.6% for pelvic control, 59.9% for distant metastasis-free survival and 81.6% for overall survival. The crude rate for G2 and G3 late toxicity was 21.7% and 4.3%. Conclusions. IGABT with the hybrid Venezia applicator and a pronounced use of a combined IC/IS technique achieved high target doses, while maintaining low doses to organs at risk, leading to excellent local control and overall survival rates with acceptable toxicity.(c) 2022 Elsevier Inc. All rights reserved.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0090-8258
• Sprache: Englisch