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. 2024 Jun 8;19(1):70.
doi: 10.1186/s13014-024-02454-1.

125I seed brachytherapy for non-central pelvic recurrence of cervical cancer after external beam radiotherapy

Xuemin Di  1 , Zhen Gao  1 , Huimin Yu  1 , Xiaoli Liu  1 , Jinxin Zhao  1 , Juan Wang  1 , Hongtao Zhang  2
Affiliations

125I seed brachytherapy for non-central pelvic recurrence of cervical cancer after external beam radiotherapy

Xuemin Di et al. Radiat Oncol. .

Abstract

Objective: To investigate the efficacy of 125I seed brachytherapy for non-central pelvic recurrence of cervical cancer after external beam radiotherapy, and to analyze the clinical influential factors.

Methods: Between June 2015 and April 2022, 32 patients with 41 lesions were treated with 125I seed brachytherapy. The seeds were implanted under the guidance of CT and/or 3D-printed template images at a median dose of 100 Gy (range, 80-120 Gy), and the local control rate (LCR) and survival rates were calculated. We used multivariate logistic regression to identify prognosis predictors, and receiver operating characteristic (ROC) curve analysis to determine the optimal cut-off values.

Results: The median follow-up was 48.52 months (range, 4-86 months), and the 6-, 12-, and 24-month LCR was 88.0%, 63.2%, and 42.1%, respectively. The 1- and 2-year survival rates were 36% and 33%, respectively, and the median survival time was 13.26 months. No significant adverse events occurred. Multivariate regression analysis showed that tumor diameter, tumor stage, and LCR were independent factors influencing survival. ROC curve analysis showed that the area under the curve for tumor diameter and D90 were 0.765 and 0.542, respectively, with cut-off values of 5.3 cm and 108.5 Gy.

Conclusions: The present findings indicate that 125I seed brachytherapy is feasible for treating non-central pelvic recurrence of cervical cancer after external beam radiotherapy. Further, tumor diameter < 5.3 cm and immediate postoperative D90 > 108.5 Gy were associated with better efficacy.

Keywords: Brachytherapy; External Beam Radiotherapy; Locoregional; Non-central pelvic recurrence of Cervical Cancer; Pelvic recurrence.

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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

Fig. 1
Fig. 1
(a) Preplan diagram of the target area made with the treatment planning system to determine the number and location of the radioactive implanted seeds and the direction and depth of the needles. (b) Three-dimensional view of the reconstructed template, needles, skin surface, tumor, and organs at risk. (c) CT scan taken 5 years after surgery showing the tumor was locally controlled and stable
Fig. 2
Fig. 2
Survival curve
Fig. 3
Fig. 3
ROC curve for maximal tumor diameter and D90
See this image and copyright information in PMC

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