Is single implant and multiple fractions radio-biologically iso-effective for cervical cancer high-dose-rate brachytherapy: Observation from patient cohorts during COVID pandemic

IF 1.8 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2026-03-01 Epub Date: 2025-12-22 DOI:10.1016/j.brachy.2025.11.010

Supriya Chopra , Asesh Samanta , Arunima Nagar , Prachi Mittal , Ankita Gupta , Jaahid Mulani , Jeevanshu Jain , Yogesh Ghadi , Prachi Sawant , Sushmita Rath , Jaya Ghosh , Sudeep Gupta

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引用次数: 0

Abstract

PURPOSE

To report clinical outcomes of cervical cancer patients treated with single implant and multiple fractions of high-dose-rate brachytherapy (HDR BT).

MATERIALS AND METHODS

Patients treated with (chemo)radiation followed by single implant with all fractionated HDR BT delivered within 24–36 hours were included. Treatment protocol recommended >70 Gy equivalent doses in 2 Gy (EQD2_10Gy) at point A for intracavitary BT (ICBT) and >85 Gy EQD2_10Gy for those receiving interstitial-intracavitary BT (IC-ISBT). Local control, locoregional control and disease-free survival was estimated along with late gastrointestinal (GI) and genitourinary (GU) toxicity.

RESULTS

From 2020–2022, 116 patients were treated with single implant multiple fractions HDR-BT. The median dose to Point A, HRCTV D90, B2cc, R2cc and S2cc was 75.1 (72.4–77.8), 80.2 (76–84), 85.2 (83.1–90.1), 69.1 (65.0–73.9) and 67.9 (61–75.3) Gy for those treated with ICBT. The median dose to high risk clinical target volume D90, Bladder 2cc, Rectum 2cc and Sigmoid 2cc was 83.2 (78.2–88.4), 87.4 (84.2–91), 69.6 (64.1–75) and 68.1 (59.5–77.1) Gy in those with IC-ISBT respectively. The median follow-up was 36 months (2–60 months). The 5-year local control, loco-regional control, disease free survival and overall survival was 89%, 84%, 70.8% and 81.6% respectively. Grade ≥3 GI and GU toxicity were 11.3% and 1.7% respectively. The incidence Grade ≥3 GI was higher in those who received 8–9 Gy in three fractions than 5–7.5 Gy in 3–4 fractions.

CONCLUSION

The abbreviated HDR BT schedule of single implant 3–4 fractions for LACC patients is radiobiological iso-effective for tumor control. There seems to be a fraction size dependence of abbreviated fractionation schedule for severe GI toxicity.

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对于宫颈癌高剂量率近距离放射治疗，单植入物和多部分放射生物学效果是否相同：来自COVID大流行期间患者队列的观察

目的：报道单次植入多段高剂量近距离放疗（HDR BT）治疗宫颈癌的临床效果。材料和方法：患者接受（化疗）放疗后单次植入，并在24-36小时内递送所有分块HDR BT。治疗方案推荐在A点接受腔内BT （ICBT）的>70 Gy当量剂量为2 Gy (EQD210Gy)，接受间质腔内BT （IC-ISBT）的>85 Gy EQD210Gy。评估局部控制、局部区域控制和无病生存以及晚期胃肠道（GI）和泌尿生殖系统（GU）毒性。结果：2020-2022年，116例患者采用单种植体多段HDR-BT治疗。接受ICBT治疗的A点、HRCTV D90、B2cc、R2cc和S2cc的中位剂量分别为75.1 Gy（72.4-77.8）、80.2 Gy（76-84）、85.2 Gy（83.1-90.1）、69.1 Gy（65.0-73.9）和67.9 Gy（61-75.3）。IC-ISBT高危临床靶体积D90、膀胱2cc、直肠2cc和乙状结肠2cc的中位剂量分别为83.2 Gy（78.2-88.4）、87.4 Gy（84.2-91）、69.6 Gy（64.1-75）和68.1 Gy（59.5-77.1）。中位随访时间为36个月（2-60个月）。5年局部对照、局部区域对照、无病生存率和总生存率分别为89%、84%、70.8%和81.6%。≥3级GI和GU毒性分别为11.3%和1.7%。3次接受8-9 Gy治疗的患者，GI等级≥3的发生率高于3-4次接受5-7.5 Gy治疗的患者。结论：LACC患者单次植入3-4次缩短HDR BT计划对肿瘤控制具有放射生物学等效。对于严重的胃肠道毒性，缩短分馏时间表似乎与分馏大小有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.