High-dose-rate interstitial brachytherapy in the management of carcinoma of the uterine cervix and other gynecologic malignancies

Objective: To report technique and experience of high-dose-rate (HDR) interstitial brachytherapy in the treatment of cervical carcinoma and other gynecologic malignancies. Material and Method: 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 hysterectomy and previous pelvic radiation. Patient characteristics, implant technique, and initial outcomes were reported. Results: Transperineal interstitial implant was performed usingfluoroscopy-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.