title: Preliminary results of magnetic resonance imaging-aided high-dose-rate interstitial brachytherapy for recurrent uterine carcinoma after curative surgery.
abstract: This report presents initial experience with imaging-aided high-dose-rate interstitial brachytherapy (HDR-ISBT) for post-operative recurrence of uterine carcinoma. Fourteen patients presenting with post-operative recurrence of uterine carcinoma (nine cervix and five corpus) between July 2005 and October 2008 were enrolled in this study (median follow-up: 37 months, range: 6-59 months). We implanted magnetic resonance imaging (MRI)-compatible plastic applicators using our own ambulatory technique. HDR-ISBT treatment consisted of twice-a-day irradiation of 6 Gy each with at least a six-hour interval to provide the total prescribed dose. Treatment was based on treatment planning-computed tomography with MRI as a reference. Seven patients were treated with a combination of ISBT (median 30 Gy/5 fractions; range: 27-33 Gy) and external beam radiation therapy (EBRT), and the other seven with brachytherapy only (median 54 Gy/9 fractions; range: 48-54 Gy), one of whom had previously received pelvic EBRT. The three-year estimates of local control and overall survival rates were 77.9% (95% confidence interval (CI): 55.8-100%) and 77.1% (95% CI: 54.2-100%), respectively. Two patients, who had received combined treatment with EBRT showed untoward reactions, including a grade 3 subileus and grade 2 constipation. Another patient, who had been treated with ISBT alone, developed grade 2 urinary constriction. Our imaging-aided HDR-ISBT for post-operative recurrence of uterine carcinoma was found to be practical with promising preliminary results.
authors.affiliation: Department of Radiation Oncology, Osaka University Graduate School of Medicine.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Kotsuma
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Takenaka
authors.forename: Kouji
authors.initials: K
authors.lastname: Konishi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koizumi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshioka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011879:Radiotherapy Dosage; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy* / Q000601:surgery