Preliminary results of magnetic resonance imaging-aidedhigh-dose-rate interstitial brachytherapy for recurrentuterine carcinoma after curative surgery

This report presents initial experience with imaging-aided high-dose-rate interstitial brachytherapy (hdr-isbt) for post-operative recurrence of uterine carcinoma. fourteen patients presenting with post-operative recurrence of uterine carcinoma (nine cervix and five corpus) between july 2005 and october 2008 were enrolled in this study (median follow-up: 37 months,range: 6-59 months). we implanted magnetic resonance imaging (mri)-compatible plastic applicators using our own ambulatory technique. hdr-isbt treatment consisted of twice-a-day irradiation of 6 gy each with at least a six-hour interval to provide the total prescribed dose. treatment was based on treatment planning-computed tomography with mri as a reference. seven patients were treated with a combination of isbt (median 30 gy/5 fractions; range: 27-33 gy) and external beam radiation therapy (ebrt),and the other seven with brachytherapy only (median 54 gy/9 fractions; range: 48-54 gy),one of whom had previously received pelvic ebrt. the three-year estimates of local control and overall survival rates were 77.9% (95% confidence interval (ci): 55.8-100%) and 77.1% (95% ci: 54.2-100%),respectively. two patients,who had received combined treatment with ebrt showed untoward reactions,including a grade 3 subileus and grade 2 constipation. another patient,who had been treated with isbt alone,developed grade 2 urinary constriction. our imaging-aided hdr-isbt for post-operative recurrence of uterine carcinoma was found to be practical with promising preliminary results.