Clinical results of image-guided interstitial brachytherapy with or without external beam radiotherapy for postsurgical vaginal recurrence of cervical and endometrial cancers

Jpn J Radiol. 2022 Jun;40(6):639-644. doi: 10.1007/s11604-021-01229-y. Epub 2021 Dec 1.

Abstract

Purpose: This study aimed to evaluate the clinical outcome and efficacy of image-guided interstitial brachytherapy (ISBT) for postsurgical vaginal recurrence of cervical and endometrial cancers.

Materials and methods: The study included 11 patients who received CT-based image-guided high-dose-rate ISBT with or without external beam radiotherapy (EBRT). Local control, progression-free survival, and treatment-related toxicities were evaluated retrospectively.

Results: Of the 11 patients, 4 underwent ISBT with EBRT and the other 7 ISBT alone; two of the latter patients received previous pelvic radiotherapy. After a median follow-up of 43.9 months (range 3.9-92.7 months), the 2-year local control rate was 100%. The median equivalent doses in 2 Gy fractions received by at least 90% of the clinical target volume for ISBT with versus without EBRT were 82.2 Gy (range 60.4-84.2 Gy) versus 69.0 Gy (range 50.8-98.2 Gy). The 2-year progression-free survival rates after ISBT with versus without EBRT were 75% versus 80%, and the difference was not significant (p = 0.74). Grade 3 late toxicities occurred in two patients.

Conclusion: Our radiotherapy strategy using image-guided ISBT, either with or without EBRT, for postsurgical vaginal recurrence showed effective treatment outcomes.

Keywords: Brachytherapy; Image-guided brachytherapy; Vaginal recurrence.

MeSH terms

  • Brachytherapy* / methods
  • Endometrial Neoplasms* / diagnostic imaging
  • Endometrial Neoplasms* / radiotherapy
  • Endometrial Neoplasms* / surgery
  • Female
  • Humans
  • Neoplasm Recurrence, Local / radiotherapy
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods
  • Radiotherapy, Image-Guided*
  • Retrospective Studies