Salvage High-dose-rate Interstitial Brachytherapy for Pelvic Recurrent Cervical Carcinoma After Hysterectomy

Anticancer Res. 2016 May;36(5):2413-21.

Abstract

Background: The aim of this study was to report the clinical results of salvage high-dose-rate interstitial brachytherapy (HDR-ISBT) for patients with cervical cancer with pelvic recurrence after hysterectomy.

Patients and methods: When there was no indication for total pelvic extenteration (TPE) and the tumor depth was more than 5 mm of invasion in the paracolpium, salvage HDR-ISBT was applied.

Results: A total of 26 patients were included in this study. The median number of fractions and dose per fraction of HDR-ISBT were 5 (range=3-20 fractions) and 6 Gy (range=2.5-6 Gy), respectively. Three-year local control, progression-free survival, and overall survival were 51.1%, 34.4% and 57.1%, respectively. Combination of external-beam radiation therapy, clinical target volume D90 greater than 65 Gy, and dose per fraction greater than 5 Gy were associated with favorable local control.

Conclusion: For patients with recurrent cervical cancer post hysterectomy who are not candidates for TPE, salvage HDR-ISBT is a possible curative treatment modality.

Keywords: Salvage interstitial brachytherapy; high-dose-rate interstitial brachytherapy; post hysterectomy relapse; uterine cervical cancer.

MeSH terms

  • Adult
  • Aged
  • Brachytherapy*
  • Combined Modality Therapy
  • Dose-Response Relationship, Radiation
  • Female
  • Humans
  • Hysterectomy*
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Salvage Therapy
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / radiotherapy*
  • Uterine Cervical Neoplasms / surgery