High-Dose-Rate Interstitial Brachytherapy in the Management of Carcinoma of the Uterine Cervix and Other Gynecologic Malignancies
Chomporn Sitathanee, MD*, Virat Pairatchvet, MD*, Ladawan Narkwong, MD*, Putipun Puataweepong, MD*
Affiliation : * Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Objective : To report technique and experience of high-dose-rate (HDR) interstitial brachytherapy in the
treatment of cervical carcinoma and other gynecologic malignancies.
Materials and Methods : Between April 2003 and October 2004, ten patients (7-cervical carcinoma, 3-vaginal
stump carcinoma) were treated with interstitial implant. Indications for implant include previous hysterec-
tomy and previous pelvic radiation. Patient characteristics, implant technique, and initial outcomes were
reported.
Results : Transperineal interstitial implant was performed using fluoroscopy-guided technique. Brachytherapy
dose/fraction ranged from 500-750 cGy for 1 to 6 fractions. Combined external beam radiation was given in
8 patients. After 5-21 months follow-up, all the patients were alive. Local control was achieved in 9 patients.
One patient had persistent disease at the implant site. No acute complication from the procedure or serious
late complication was observed.
Conclusion : Interstitial implant can be a treatment option in patients with gynecologic malignancies who
have limitations with standard intracavitary insertion. This technique is feasible, providing good local
control without serious complications. However, long term follow-up is needed.
Keywords : Interstitial implant, Brachytherapy, Cervical carcinoma, Gynecologic malignancies
