Application of the Third-generation Intracavitary Combined With Interstitial Brachytherapy Applicator Template for Cervical Cancer
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2025.0220
- VernacularTitle:第三代宫颈癌腔内联合组织间插植近距离放疗施源器模板的应用
- Author:
Xiang ZHOU
1
;
Xiaodan HUANG
2
;
Huimin XU
1
;
Yi OUYANG
2
Author Information
1. Department of Oncology， YiYang Central Hospital， YiYang 413000，China
2. Department of Radiation Oncology， Sun Yat-sen University Cancer Center， Guangzhou 510060，China
- Publication Type:Journal Article
- Keywords:
cervical cancer;
intracavitary combined with interstitial;
brachytherapy applicator template;
freehand insertion;
dosimetry
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(2):354-360
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate a third-generation applicator template for intracavitary combined with interstitial brachytherapy （IC-ISBT） suitable for locally advanced cervical cancer， aiming to improve therapeutic outcomes. MethodsA retrospective study was conducted on patients with stage IB3-ⅣB cervical cancer treated at Sun Yat-sen University Cancer Center from January 2023 to October 2023. Magnetic resonance imaging data before and after external beam radiation therapy were collected and analyzed. According to the residual tumor after external beam radiation， high-risk clinical target volumes （HR-CTV） were delineated， based on which a third-generation IC-ISBT applicator template was designed. The dosimetric and therapeutic differences between using this applicator template （template implantation group） and traditional freehand interstitial implantation （freehand implantation group） were further compared. Statistical methods were used to analyze the data from both groups to test the efficacy and safety of the two approaches. ResultsThe third-generation applicator template could accommodate different cervical structures and optimize needle path layout. The tumor volume in the template implantation group was significantly larger than in the freehand implantation group， showing statistical differences. In terms of dosimetric coverage （V100%）， the template implantation group exhibited significant statistical differences compared with the freehand implantation group， demonstrating superior dose coverage. Additionally， the third-generation template showed advantages in protecting the rectum and sigmoid colon by potentially reducing high-dose points， while there were no significant differences in bladder dosimetry between the two methods. The primary cervical lesion remission rates were similar between the two groups. ConclusionThe third-generation IC-ISBT applicator template is scientifically and rationally designed， especially for patients with larger tumor volumes and later stages. It is easy to operate， highly reproducible， and shows significant advantages in dose distribution and protection of surrounding critical organs. The template has the potential to be widely applied as a routine treatment option.
