Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia
Abstract Background Three‐dimensional image‐guided brachytherapy is the standard of care in cervical cancer radiotherapy. In addition, the usefulness of the so‐called “hybrid brachytherapy (HBT)” has been reported, which involves the addition of needle applicators to conventional intracavitary brach...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-11-01
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| Series: | Cancer Reports |
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| Online Access: | https://doi.org/10.1002/cnr2.1607 |
| _version_ | 1797984222413062144 |
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| author | Noriyuki Okonogi Kazutoshi Murata Toshiaki Matsui Yuma Iwai Yasumasa Mori Takashi Kaneko Masaru Wakatsuki Hiroshi Tsuji |
| author_facet | Noriyuki Okonogi Kazutoshi Murata Toshiaki Matsui Yuma Iwai Yasumasa Mori Takashi Kaneko Masaru Wakatsuki Hiroshi Tsuji |
| author_sort | Noriyuki Okonogi |
| collection | DOAJ |
| description | Abstract Background Three‐dimensional image‐guided brachytherapy is the standard of care in cervical cancer radiotherapy. In addition, the usefulness of the so‐called “hybrid brachytherapy (HBT)” has been reported, which involves the addition of needle applicators to conventional intracavitary brachytherapy for interstitial irradiation. Aim To evaluate the clinical outcomes of CT‐based HBT consisting of transvaginal insertion of needle applicators (CT‐based transvaginal HBT) and only intravenous sedation without general or saddle block anesthesia. Methods and results This is a retrospective chart review of patients who received definitive radiotherapy, including CT‐based transvaginal HBT, between February 2012 and July 2019. The inclusion criteria were as follows: (i) histologically diagnosed disease, (ii) untreated cervical cancer, (iii) International Federation of Gynecology and Obstetrics (FIGO) stage IB1–IVA disease in the 2008 FIGO staging system, and (iv) patients who underwent CT‐based transvaginal HBT at least once in a series of intracavitary brachytherapy. Overall, 54 patients fulfilled the eligibility criteria in the present study. The median follow‐up period was 32 (IQR, 19–44) months. No patient complained of symptoms such as persistent bleeding or abdominal pain after the treatment. The 3‐year local control (LC), disease‐free survival, and overall survival rates for all 54 patients were 86.6%, 60.3%, and 90.7% (95% CI [81.3%–100.0%]), respectively. The 3‐year LC rate was 87.7% in patients with FIGO III–IVA and 90.4% in tumor size >6.0 cm. The incidence rate of late adverse events, grade ≥3, in the rectum and bladder was 0% and 1.8%, respectively. In the dose‐volume histogram analyses, transvaginal HBT increased the dose of HR‐CTVD90 by ~7.5% without significantly increasing the dose of organs at risk. Conclusion Considering the favorable clinical outcomes, CT‐based transvaginal HBT may be a good option for treating cervical cancer. |
| first_indexed | 2024-04-11T06:58:08Z |
| format | Article |
| id | doaj.art-b341b3e9a70d48e0971b69e252b07785 |
| institution | Directory Open Access Journal |
| issn | 2573-8348 |
| language | English |
| last_indexed | 2024-04-11T06:58:08Z |
| publishDate | 2022-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Reports |
| spelling | doaj.art-b341b3e9a70d48e0971b69e252b077852022-12-22T04:38:56ZengWileyCancer Reports2573-83482022-11-01511n/an/a10.1002/cnr2.1607Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesiaNoriyuki Okonogi0Kazutoshi Murata1Toshiaki Matsui2Yuma Iwai3Yasumasa Mori4Takashi Kaneko5Masaru Wakatsuki6Hiroshi Tsuji7QST Hospital, National Institutes for Quantum Science and Technology Chiba JapanQST Hospital, National Institutes for Quantum Science and Technology Chiba JapanQST Hospital, National Institutes for Quantum Science and Technology Chiba JapanQST Hospital, National Institutes for Quantum Science and Technology Chiba JapanQST Hospital, National Institutes for Quantum Science and Technology Chiba JapanQST Hospital, National Institutes for Quantum Science and Technology Chiba JapanQST Hospital, National Institutes for Quantum Science and Technology Chiba JapanQST Hospital, National Institutes for Quantum Science and Technology Chiba JapanAbstract Background Three‐dimensional image‐guided brachytherapy is the standard of care in cervical cancer radiotherapy. In addition, the usefulness of the so‐called “hybrid brachytherapy (HBT)” has been reported, which involves the addition of needle applicators to conventional intracavitary brachytherapy for interstitial irradiation. Aim To evaluate the clinical outcomes of CT‐based HBT consisting of transvaginal insertion of needle applicators (CT‐based transvaginal HBT) and only intravenous sedation without general or saddle block anesthesia. Methods and results This is a retrospective chart review of patients who received definitive radiotherapy, including CT‐based transvaginal HBT, between February 2012 and July 2019. The inclusion criteria were as follows: (i) histologically diagnosed disease, (ii) untreated cervical cancer, (iii) International Federation of Gynecology and Obstetrics (FIGO) stage IB1–IVA disease in the 2008 FIGO staging system, and (iv) patients who underwent CT‐based transvaginal HBT at least once in a series of intracavitary brachytherapy. Overall, 54 patients fulfilled the eligibility criteria in the present study. The median follow‐up period was 32 (IQR, 19–44) months. No patient complained of symptoms such as persistent bleeding or abdominal pain after the treatment. The 3‐year local control (LC), disease‐free survival, and overall survival rates for all 54 patients were 86.6%, 60.3%, and 90.7% (95% CI [81.3%–100.0%]), respectively. The 3‐year LC rate was 87.7% in patients with FIGO III–IVA and 90.4% in tumor size >6.0 cm. The incidence rate of late adverse events, grade ≥3, in the rectum and bladder was 0% and 1.8%, respectively. In the dose‐volume histogram analyses, transvaginal HBT increased the dose of HR‐CTVD90 by ~7.5% without significantly increasing the dose of organs at risk. Conclusion Considering the favorable clinical outcomes, CT‐based transvaginal HBT may be a good option for treating cervical cancer.https://doi.org/10.1002/cnr2.1607brachytherapycervical cancerhybrid brachytherapyinterstitial brachytherapyintracavitary brachytherapyradiotherapy |
| spellingShingle | Noriyuki Okonogi Kazutoshi Murata Toshiaki Matsui Yuma Iwai Yasumasa Mori Takashi Kaneko Masaru Wakatsuki Hiroshi Tsuji Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia Cancer Reports brachytherapy cervical cancer hybrid brachytherapy interstitial brachytherapy intracavitary brachytherapy radiotherapy |
| title | Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia |
| title_full | Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia |
| title_fullStr | Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia |
| title_full_unstemmed | Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia |
| title_short | Clinical advantage and outcomes of computed tomography‐based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia |
| title_sort | clinical advantage and outcomes of computed tomography based transvaginal hybrid brachytherapy performed only by sedation without general or saddle block anesthesia |
| topic | brachytherapy cervical cancer hybrid brachytherapy interstitial brachytherapy intracavitary brachytherapy radiotherapy |
| url | https://doi.org/10.1002/cnr2.1607 |
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