Indications And Rationale For High-Dose-Rate Interstitial Brachytherapy In The Management of Carcinoma Cervix and Other Gynaecologic Malignancies
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 11
Abstract
Objective:To report indications, rationale and technique of high-dose-rate (HDR) interstitial brachytherapy in the treatment of cervical carcinoma and other gynaecologic malignancies. Materials and Methods:Between 2014 and 2017, 45 patients (35 - cervical carcinoma, 8 –Ca vaginal vault, 1 – Ca cervical stump and 1 – Ca vagina) were treated with interstitial implant. Patient characteristics, implant technique, and indications were reported. Results:All patients completed EBRT prior to brachytherapy and underwent an interstitial implant using a MUPIT applicator. Clinical and imaging findings prior to EBRT and brachytherapy were used to estimate tumour volume and number of needles required for implantation. 71% of patients received external beam RT to a dose of 50Gy in 25 fractions. 38 patients received concurrent cisplatin along with radiotherapy. ISBT dose ranged from 8Gy to 22.5Gy. The indications for interstitial brachytherapy for patients in our study are bulky parametrial disease (n = 27), extensive vaginal extension (n = 11), bulky primary disease (n= 10), recurrent disease post hysterectomy (n = 8), adjacent organ invasion (n = 7), presence of fistula (n = 4), obliteration of cervical os (n = 4), recurrent disease after pelvic RT (n = 2) and Carcinoma cervical stump (n = 1). Conclusion:Interstitial implant can be a feasible treatment option in patients with gynaecologic malignancies who have limitations with standard intracavitary insertion. The case selection for interstitial brachytherapy should be done judiciously
Authors and Affiliations
Dr. George John, Dr. Hasib A. G, Mr. Sridhar C. H, Dr. M. S Athiyamaan, Dr. Sandesh Rao, Dr. Sharaschandra Shankar, Dr. Pavan Kumar Reddy, Dr. Priyanka Augustine
Keywords
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- EP ID EP249529
- DOI 10.9790/0853-1611102328
- Views 70
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