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Case Reports
. 2024 Jan 15:13:1330681.
doi: 10.3389/fonc.2023.1330681. eCollection 2023.

Successful inguinal interstitial brachytherapy in metastatic cervical carcinoma: a case report

Yi Qin #  1 , Ping Guan #  1   2 , Dan Li  1 , Huailin He  1 , Wenfeng He  1 , Longjing Tan  1 , Xiangyu Deng  1 , Bizhen Liao  2 , Qinglian Wen  3 , Zhenhua Zhang  1
Affiliations
Case Reports

Successful inguinal interstitial brachytherapy in metastatic cervical carcinoma: a case report

Yi Qin et al. Front Oncol. .

Abstract

Background: Treatment of metastatic cervical cancer is a tricky issue. Currently, the National Comprehensive Cancer Network (NCCN) guideline recommends chemotherapy combined with bevacizumab for recurrent or metastatic cervical cancer. Still, the recurrence rate is high and the survival rate is low after standard treatment. We urgently need to achieve a multimodal therapy approach for recurrent or metastatic cervical cancer.

Case description: We report the case of a patient with stage IB2 cervical squamous carcinoma who developed multiple metastases within a short term after receiving first-line standard treatment, and she underwent interstitial brachytherapy after systemic therapy with an encouraging outcome. The patient developed suspected inguinal lymph node metastases after 9 months at the end of first-line therapy and multiple metastases in the inguinal lymph nodes, anterior abdominal wall, and right lung after 17 months. As the patient had residual inguinal lymph nodes after systemic therapy, she received 3D-printed template-guided interstitial brachytherapy to the inguinal lymph nodes and maintenance therapy. By Sep 2023, she had achieved a good treatment outcome with a progression-free survival (PFS) of 36 months.

Conclusion: Based on our patient response, when multiple metastases develop in the short term in early-stage cervical squamous carcinoma after first-line therapy, we may consider implementing local therapy combined with systemic therapy.

Keywords: anlotinib; case report; cervical carcinoma; interstitial brachytherapy; multiple metastases.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Timeline of different treatments and disease status.
Figure 2
Figure 2
CT of the lungs before and after palliative chemotherapy. (A) CT after 17 months of first-line treatment: an approximately 4 mm diameter solid nodular shadow was seen in the right upper lung posterior segment. (B) CT after palliative chemotherapy: no significant shadows or nodules were seen in both lungs.
Figure 3
Figure 3
3D printed templates guide interstitial brachytherapy. (A) 3D printed molds of the patient’s inguinal region. (B) Three-dimensional conformal dose assessment.
Figure 4
Figure 4
MRI of the inguinal region before and after interstitial brachytherapy. (A) MRI at the end of the palliative chemotherapy. (B) MRI of the inguinal region 3 months after interstitial brachytherapy. (C) MRI of the inguinal region 1 year after interstitial brachytherapy.
See this image and copyright information in PMC

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