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High-Dose-Rate Interstitial Brachytherapy in the Management of Carcinoma of the Uterine Cervix and Other Gynecologic Malignancies


Chomporn Sitathanee, MD*, Virat Pairatchvet, MD*,
Ladawan Narkwong, MD*, Putipun Puataweepong, MD*

* Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University


Objective: To report technique and experience of high-dose-rate (HDR) interstitial brachytherapy in the treatment of cervical carcinoma and other gynecologic malignancies.
Material and Method: Between April 2003 and October 2004, ten patients (7-cervical carcinoma, 3-vaginal stump carcinoma) were treated with interstitial implant. Indications for implant include previous hysterectomy and previous pelvic radiation. Patient characteristics, implant technique, and initial outcomes were reported.
Results: Transperineal interstitial implant was performed using fluoroscopy-guided technique. Brachytherapy dose/fraction ranged from 500-750 cGy for 1 to 6 fractions. Combined external beam radiation was given in 8 patients. After 5-21 months follow-up, all the patients were alive. Local control was achieved in 9 patients. One patient had persistent disease at the implant site. No acute complication from the procedure or serious late complication was observed.
Conclusion: Interstitial implant can be a treatment option in patients with gynecologic malignancies who have limitations with standard intracavitary insertion. This technique is feasible, providing good local control without serious complications. However, long term follow-up is needed.

Keyword : Interstitial implant, Brachytherapy, Cervical carcinoma, Gynecologic malignancies

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