The application of 3D brachytherapy in cervical stump cancer: A retrospective study

Yuxuan Wang; Xue Qin Wang; Lang Yu; Xiaorong Hou; Ke Hu; Junfang Yan; Fuquan Zhang

doi:10.5114/jcb.2023.130898

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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4/2023
vol. 15

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abstract:

Original paper

The application of 3D brachytherapy in cervical stump cancer: A retrospective study

Yuxuan Wang

^{1, 2}

,

Xue Qin Wang

^{1, 3}

,

Lang Yu

¹

,

Xiaorong Hou

¹

,

Ke Hu

¹

,

Junfang Yan

¹

,

Fuquan Zhang

^{1, 4}

Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
Peking Union Medical College, MD Program; No. 9 Dongdansantiao, Beijing, China
Department of Obstetrics and Gynecology, Luohe Central Hospital, Luohe, China
Department of Radiation Oncology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China

J Contemp Brachytherapy 2023; 15, 4: 275–282

DOI: https://doi.org/10.5114/jcb.2023.130898

Online publish date: 2023/08/31

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Purpose:
Cervical stump cancer is a carcinoma that grows on the cervical stump after a sub-total hysterectomy. There have been no studies on the application of 3D brachytherapy in cervical stump cancer. In the present study, we aimed to compare the curative effects, toxicity, and dosimetry of 3D and 2D brachytherapy in cervical stump cancer.

Material and methods:
Thirty-one patients admitted between 2012 and 2021, who were concurrently treated with intensity-modulated radiation therapy and brachytherapy for cervical stump cancer were divided into three groups according to the brachytherapy techniques: 2D brachytherapy, 3D image-guided brachytherapy (3D-IGBT), and 2D + 3D. For patients undergoing 2D brachytherapy and 3D-IGBT, data on survival, complications, and dose to target area or organs at risk (OARs) were collected and compared. Furthermore, dosimetry difference was investigated by reconstructing the 2D plan into a 3D plan.

Results:
The median follow-up duration of all patients was 58 months. The overall 5-year progression-free survival, overall survival, and local control rates were 69.6%, 90.2%, and 78.2%, respectively. Late complications in the rectum, sigmoid colon, and bladder were milder in 3D brachytherapy than in 2D brachytherapy. Concerning the D₉₀ value of clinical target volume (CTV) and D2_cm³ value of OARs in EQD2, the 3D brachytherapy provided a lower dose to CTV (76.5 Gy vs. 95.9 Gy, on average) and OARs compared with 2D brachytherapy.

Conclusions:
Despite lacking statistical significance, 3D brachytherapy showed better outcomes regarding late toxicity than 2D brachytherapy, owing to the lower dose coverage in the bladder, rectum, sigmoid colon, and small intestine.

keywords:

The application of 3D brachytherapy in cervical stump cancer: A retrospective study

Yuxuan Wang 1, 2 , Xue Qin Wang 1, 3 , Lang Yu 1 , Xiaorong Hou 1 , Ke Hu 1 , Junfang Yan 1 , Fuquan Zhang 1, 4

brachytherapy, sub-total hysterectomy, cervical stump cancer, 3D image-guided brachytherapy

Yuxuan Wang

^{1, 2}

,

Xue Qin Wang

^{1, 3}

,

Lang Yu

¹

,

Xiaorong Hou

¹

,

Ke Hu

¹

,

Junfang Yan

¹

,

Fuquan Zhang

^{1, 4}