Cervical cancer is a major world health problem and it is the fourth most common cancer in women worldwide,
with 85% of cases occurring in developing countries,
where cervical cancer is a leading cause of cancer death in women [1-3].
The standard treatment for locally advanced cervical cancer (stages IB2 to IVA) is external beam radiation therapy with concurrent chemotherapy followed by brachytherapy (NCCN).
Intracavitary brachytherapy facilitates a high radiation dose to cervical cancer with relative sparing of normal tissues and is an integral component...
Methods and materials
The clinical and radiologic data of 142 patients who received tandem-based intracavitary brachytherapy after external beam pelvic radiotherapy at the Acibadem Adana Hospital between January 2010 and June 2015 were retrospectively reviewed. Within our hospital,
cervical cancer patients are generally treated with external bean pelvic radiotherapy (45-50.4 Gy) followed by high dose rate tandem-based intracavitary brachytherapy with curative intent.
The whole brachytherapy procedures were performed in a brachytherapy suite with dedicated and specialized staff,
including registered nurses and physicists,
together with the attending radiation oncologist...
Between January 2010 and June 2015,
412 insertions for intracavitary brachytherapy was performed under ultrasound guidance in 113 consecutive patients with cervical cancer.
application for 29 patients was done without ultrasound guidance and 2 patients had uterine perforations (6.9%).
The patients were treated with 3D conformal brachytherapy and CT imaging was used for treatment planning.
After detecting uterine perforations with planning tomography,
we decided to perform ultrasound guidance for applicator insertions.
Only one of 113 patients after ultrasound guidance had uterine perforation (0.9%).
In this study,
we have presented that routine ultrasound guidance during intracavitary brachytherapy for cervical cancer patients may result in appropriate insertion and very low rates of uterine perforation.
Previous studies have shown perforation rates ranging from 1.4 to 13.7% [4-9].
Before ultrasound guidance in our patients,
our perforation rate was 6.9%,
but after ultrasound guidance perforation was detected only in one patient (0.9%).
Since perforation may lead to direct trauma to the surrounding organs,
such as bladder and intestine,
and increases radiation dose to...
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Accessed November 10,
JF De Los Santos,