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EP067/#487  Efficacy of interstitial brachytherapy for the patient with locally advanced cervical cancer
  1. Tetsuya Kokabu1,
  2. Koji Masui2,
  3. Kohei Aoyama1,
  4. Yosuke Tarumi1,
  5. Hisashi Kataoka1,
  6. Kaori Yoriki1 and
  7. Taisuke Mori1
  1. 1Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Department of Obstetrics and Gynecology, Kyoto, Japan
  2. 2Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Department of Radiology, Kyoto, Japan


Introduction Locally advanced cervical cancers with bulky and asymmetrical tumors treated with intracavitary brachytherapy are more likely to relapse in a few years due to insufficient dose prescription to the entire tumor, resulting in poor prognosis. The purpose of this study is to evaluate the efficacy and safety of 3-dimennsional (3D) image-guided multi-catheter interstitial brachytherapy, which could increase flexibility in dose distribution for patients with bulky (≥4 cm) and high-risk, stage IIB-IVA advanced cervical cancer.

Methods Twenty one patients who underwent concurrent chemoradiotherapy with multi-catheter interstitial brachytherapy between September 2014 and February 2023 were enrolled. The prescribed dose of external beam radiotherapy was 45–50.4 Gy, and the total dose of interstitial brachytherapy was 25–30 Gy per 5 fractions. The endpoints were 5-year local and pelvic control rates, 5-year disease-free and overall survival rates, and the adverse events rate.

Results The median follow-up period was 53.5 months (4.1–102.0 months). Eighteen patients received concurrent cisplatin therapy (40 mg/m2, q1week). Five (23.9%), ten (47.6%), and six (28.6%) patients had T2b, T3b, and T4 cervical cancer, respectively. Pelvic and para-aortic lymph node metastases were detected in 13 (61.9%) and 3 (14.3%) patients, respectively. The median volume before interstitial brachytherapy was 42.6 cm3. The 5-year local control, pelvic control, progression free survival, and overall survival rates were 95.0%, 87.7%, 78.3%, and 83.2%, respectively. Four (19.0%) patients experienced grade 3 adverse events, and none experienced grade 4–5 adverse events.

Conclusion/Implications 3D image-guided multi-catheter interstitial brachytherapy could be a promising therapeutic strategy for locally advanced cervical cancer.

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