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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 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.