RT Journal Article
SR Electronic
T1 Intraoperative Ultrasound Guidance During Intracavitary Brachytherapy Applicator Placement in Cervical Cancer: The University of Alabama at Birmingham Experience
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 559
OP 566
DO 10.1097/IGC.0b013e3182859302
VO 23
IS 3
A1 Schaner, Philip E.
A1 Caudell, Jimmy J.
A1 De Los Santos, Jennifer F.
A1 Spencer, Sharon A.
A1 Shen, Sui
A1 Kim, Robert Y.
YR 2013
UL http://ijgc.bmj.com/content/23/3/559.abstract
AB Objective The objective of this study was to evaluate the University of Alabama at Birmingham experience with routine intraoperative ultrasound (IUS)–guided tandem placement for cervical cancer.Methods Between 1999 and 2008, 243 cervical cancer patients underwent IUS-guided tandem placement. One hundred thirty-nine patients received low-dose-rate brachytherapy, and 104 received high-dose-rate brachytherapy. Three hundred fifty-six IUS-guided procedures were performed. Clinical and imaging data were retrospectively analyzed to evaluate complications requiring reinsertion of tandem placement in the context of IUS.Results All 243 cervical cancer patients completed intracavitary brachytherapy. Five (1.4%) of 356 IUS-guided applicator placements resulted in uterine perforation. All of these patients underwent successful tandem insertion on the second attempt, and no significant clinical sequelae occurred. Intraoperative ultrasound enabled direct uterine visualization and facilitated real-time feedback for selection of a suitable tandem length and curvature; no suboptimal placements requiring return to the operating room occurred (excluding perforation).Conclusions In this large series, IUS guidance substantially increased the rate of successful applicator placement and diminished the rate of uterine perforation relative to historical controls. We strongly recommend the use of IUS guidance during operative intrauterine tandem placement for cervical cancer.