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

Content Provider	Europe PMC
Author	Scharl, Sophia Hugo, Christine Weidenbächer, Clara-Bianca Bronger, Holger Brambs, Christine Kiechle, Marion Makowski, Marcus R. Combs, Stephanie E. Schüttrumpf, Lars
Abstract	PurposeBrachytherapy 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.MethodsTwenty 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.ResultsD90 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.ConclusionIn 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.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00404-022-06602-4.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9918574&blobtype=pdf
ISSN	09320067
Journal	Archives of Gynecology and Obstetrics [Arch Gynecol Obstet]
Volume Number	307
DOI	10.1007/s00404-022-06602-4
PubMed Central reference number	PMC9918574
Issue Number	2
PubMed reference number	35639163
e-ISSN	14320711
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2022-05-31
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2022
Subject Keyword	Cervical cancer Brachytherapy Heyman capsules Tandem-ring applicator
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology