Preliminary Experience with Electronic Brachytherapy in the Treatment of Locally Advanced Cervical Carcinoma

Simple Summary

The current study aims to investigate the dosimetric and clinical results of the treatment of locally advanced cervical cancer with electronic brachytherapy. A total of 25 patients were treated with chemoradiotherapy and intracavitary electronic brachytherapy. After a median follow-up of 12 months, 84% of the patients achieved local control in the cervix, and a complete response was noted in 72% of the patients. The method demonstrated safety with its low toxicity. This paper discusses methods for further improvement of the treatment protocol and highlights the necessity for more studies on the matter.

Abstract

Background/Objectives: Image-guided adaptive brachytherapy is a standard modality in the treatment of locally advanced cervical cancer. However, the availability of isotope-based brachytherapy is limited in countries with lower resources. The objective of this study is to report the first institutional dosimetric and clinical data on intracavitary electronic brachytherapy. Methods: A total of 25 patients with histologically proven cervical cancer stage IB-IVA were treated with concurrent chemoradiotherapy and electronic brachytherapy. The patients were followed up for a median of 12 months (range 6–24). Toxicity was evaluated by the radiation oncologist and gynecologist on each visit and scored by Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Results: All patients completed the treatment successfully with a median overall treatment time (OTT) of 52 days (range 39–89). The desired target coverage was achieved in all patients, and the dose limits for the organs at risk were achieved in 88% of the patients. No Grade 3 toxicities occurred. A total of 84% of the patients achieved local control in the cervix, and a complete response was noted in 72% of the patients. Conclusions: Electronic brachytherapy provides the option to deliver a high dose of radiation to the uterine cervix without leading to severe toxicity. Further improvements to the treatment protocol could provide better locoregional and systemic control of the disease. Studies with larger cohorts and longer follow-up are necessary.

Keywords: cervical cancer; electronic brachytherapy; radiotherapy