Intracavitary brachytherapy with additional Heyman capsules in the treatment of cervical cancer.

Scharl, Sophia; Hugo, Christine; Weidenbächer, Clara-Bianca; Bronger, Holger; Brambs, Christine; Kiechle, Marion; Makowski, Marcus R; Combs, Stephanie E; Schüttrumpf, Lars

doi:10.1007/s00404-022-06602-4

2023

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Title:: Intracavitary brachytherapy with additional Heyman capsules in the treatment of cervical cancer.
Document type:: Journal Article; Research Support, Non-U.S. Gov't
Author(s):: Scharl, Sophia; Hugo, Christine; Weidenbächer, Clara-Bianca; Bronger, Holger; Brambs, Christine; Kiechle, Marion; Makowski, Marcus R; Combs, Stephanie E; Schüttrumpf, Lars
Abstract:: PURPOSE: Brachytherapy is a mandatory component of primary radiochemotherapy in cervical cancer. The dose can be applied with a traditional intracavitary approach (IC alone) or with multiple catheter brachytherapy to optimize dose distribution in an individual concept. We therefore evaluated whether the utilization of a tandem-ring applicator plus additional intracavitary applicators (add IC) provides an advantage over the traditional IC alone approach, as this method is less time consuming and less invasive compared to a combined intracavitary/interstitial brachytherapy. METHODS: Twenty three procedures of intracavitary brachytherapy for cervical cancer with additional intracavitary applicators performed in seven patients treated between 2016 and 2018 in our institution were included in this study. Plans were optimized for D90 HR-CTV with and without the utilization of the additional applicators and compared by statistical analysis. RESULTS: D90 for HR-CTV was 5.71 Gy (±1.17 Gy) for fractions optimized with add IC approach and 5.29 Gy (±1.24 Gy) for fractions without additional applicators (p < 0.01). This translates to a calculated mean EQD2 HR-CTV D90 of 80.72 Gy (±8.34 Gy) compared to 77.84 Gy (±8.49 Gy) after external beam therapy and four fractions of brachytherapy for add IC and IC alone, respectively (p < 0.01). The predictive value of improved coverage of HR-CTV in the first fraction was high. CONCLUSION: In a subgroup of cases, the addition of intracavitary Heyman capsules can be an alternative to interstitial brachytherapy to improve the plan quality compared to standard IC alone brachytherapy. The benefit from the addition of applicators in the first fraction is predictive for the following fractions.
Journal title abbreviation:: Arch Gynecol Obstet
Year:: 2023
Journal volume:: 307
Journal issue:: 2
Pages contribution:: 557-564
Fulltext / DOI:: doi:10.1007/s00404-022-06602-4
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/35639163
Print-ISSN:: 0932-0067
TUM Institution:: Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski); Klinik und Poliklinik für Frauenheilkunde (Prof. Kiechle); Klinik und Poliklinik für RadioOnkologie und Strahlentherapie (Prof. Combs)
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