Image-guided interstitial high-dose-rate brachytherapy for locally recurrent uterine cervical cancer: A single-institution study

Rei Umezawa, Naoya Murakami, Satoshi Nakamura, Akihisa Wakita, Hiroyuki Okamoto, Keisuke Tsuchida, Tairo Kashihara, Kazuma Kobayashi, Ken Harada, Kana Takahashi, Koji Inaba, Yoshinori Ito, Hiroshi Igaki, Koji Masui, Ken Yoshida, Keiichi Jingu, Nikolaos Tselis, Jun Itami

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9 Citations (Scopus)

Abstract

Purpose: The aim of this study was to investigate the efficacy and safety of image-guided high-dose-rate (HDR) interstitial brachytherapy (ISBT) for reirradiation of locally recurrent uterine cervical cancer. Methods and Materials: Between 2008 and 2015, patients receiving reirradiation using HDR-ISBT for local gross recurrence of uterine cervical cancer after definitive or postoperative radiotherapy were analyzed retrospectively. The prescription doses per fraction ranged 2.5–6.0 Gy, whereas the cumulative equivalent doses in 2 Gy fractions ranged 48.6–82.5 Gy. The effects of prognostic factors on the local control (LC), progression-free survival, and overall survival were analyzed, and late toxicity data were evaluated. Results: Eighteen patients were included in the analysis, with a median followup of 18.1 months. A tumor response was obtained in all patients, with radiological and pathological complete remission seen in 12 (66.7%) patients. The 2-year LC, progression-free survival, and overall survival rates for all patients were 51.3%, 20.0%, and 60.8%, respectively. The hemoglobin level and maximum tumor diameter were shown to be statistically significant prognostic factors for LC (p = 0.028 and 0.009, respectively). Late ≥ Grade 2 adverse events were observed in 5 patients (27.8%). Conclusions: Image-guided HDR-ISBT for the reirradiation of locally recurrent uterine cervical cancer may play an important role for local tumor control in a subgroup of patients. However, the treatment indication must be weighed against the risk of higher-grade late toxicity.

Original languageEnglish
Pages (from-to)368-376
Number of pages9
JournalBrachytherapy
Volume17
Issue number2
DOIs
Publication statusPublished - 2018 Mar

Keywords

  • High-dose-rate brachytherapy
  • Image-guided brachytherapy
  • Reirradiation
  • Uterine cervical cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Umezawa, R., Murakami, N., Nakamura, S., Wakita, A., Okamoto, H., Tsuchida, K., Kashihara, T., Kobayashi, K., Harada, K., Takahashi, K., Inaba, K., Ito, Y., Igaki, H., Masui, K., Yoshida, K., Jingu, K., Tselis, N., & Itami, J. (2018). Image-guided interstitial high-dose-rate brachytherapy for locally recurrent uterine cervical cancer: A single-institution study. Brachytherapy, 17(2), 368-376. https://doi.org/10.1016/j.brachy.2017.11.011