Journal article
A practical guide to hybrid interstitial/intracavitary brachytherapy for locally-advanced cervical cancer
Brachytherapy, v 22(5), pp 640-648
01 Sep 2023
PMID: 37481370
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
In select cases of locally advanced cervical cancer, a hybrid brachytherapy (HBT) approach consisting of a combined intracavitary (IC)/insterstitial (IS) implant can yield improved target coverage and/or decreased organ at risk dose compared to IC techniques while limiting invasiveness compared to IS techniques.
The technique involves placement of transvaginal and/or perineal needles in addition to the tandem and ring/ovoids using either a specialized applicator or free-hand placement. Following applicator and needle placement, brachytherapy may then be planned using principles similar to IC or IS techniques. During treatment planning, it can be helpful to obtain both MRI and CT imaging, as plastic MRI-compatible needles do not show up well on MRI.
In patients where acceptable target coverage cannot be achieved using IC alone or doses to nearby OAR are too high, HBT should be evaluated. HBT can improve both dose to target and OAR while sparing patients the morbidity of perineal template-based interstitial brachytherapy. Specific scenarios where HBT may be preferred include bulky residual primary tumor especially with poor response to EBRT, extension into the lateral parametrium, vaginal extension of tumor, and an asymmetric target. Use of HBT can typically permit extension of dose coverage by an additional 1–2 cm beyond what can be achieved with an IC alone technique.
HBT allows for improved therapeutic ratio by improving target volume coverage and/or lowering doses to OARs. Brachytherapists should be trained on the practical aspects of administering HBT to be able to offer a less invasive and impactful treatment option when appropriate.
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Details
- Title
- A practical guide to hybrid interstitial/intracavitary brachytherapy for locally-advanced cervical cancer
- Creators
- Colton Ladbury - City Of Hope National Medical CenterMatthew Harkenrider - Loyola University ChicagoNeil Taunk - University of PennsylvaniaChristine Fisher - University of Colorado Anschutz Medical CampusJyoti Mayadev - University of California, San DiegoPuja Venkat - University of California, Los AngelesCatheryn Yashar - University of California, San DiegoDavid Gaffney - Huntsman Cancer InstituteSushil Beriwal - Allegheny Health NetworkScott Glaser - City Of Hope National Medical Center
- Publication Details
- Brachytherapy, v 22(5), pp 640-648
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:001079426800001
- Scopus ID
- 2-s2.0-85165647454
- Other Identifier
- 991021897380204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging