Efficacy of three-dimensional image-guided 192 Ir interstitial brachytherapy in the treatment of locally advanced cervical cancer
CHANG Shichuan
HUANG Xiaoping
FANG Zhixiang
HUANG Shuangyan
ZHANG Longbin
Abstract：Objective To observe the efficacy of three-dimensional image-guided Iridium-192(192Ir)interstitial brachytherapy in the treatment of locally advanced cervical cancer(LACC).Methods A total of 100 patients with LACC were divided into the study group(n=58)and the control group(n=42).Both groups received pelvic intensity-mod-ulated radiation therapy combined with concurrent chemotherapy.The study group was treated with three-dimensional im-age-guided ¹⁹²Ir interstitial brachytherapy,while the control group received conventional intracavitary brachytherapy.We compared the target volume dosimetric parameters[the minimum radiation dose received by 90%of the high-risk clinical target volume(HRCTV-D90),dose conformity index,homogeneity index,and the minimum radiation dose received by 2 cubic centimeters of the rectum,bladder,and colon(D2cc)],short-term efficacy[complete response(CR),partial re-sponse(PR),stable disease(SD),progressive disease(PD),and objective response rate(ORR)],quality of life(Kar-nofsky performance score),and incidence of adverse reactions between the two groups.Cox proportional hazards regres-sion model was used to analyze the independent influencing factors of progression-free survival(PFS).Results The HRCTV-D90 and dose conformity index in the study group were significantly higher than those in the control group,while the homogeneity index was significantly lower(all P<0.01).The rectal D2cc and bladder D2cc in the study group were signif-icantly lower than those in the control group(both P<0.01).At 3 months after treatment,the CR rate and ORR in the study group were significantly higher than those in the control group,and the improvement rate of Karnofsky score in the study group was also significantly higher than that in the control group(all P<0.05).During the 18-month follow-up,the PFS rate and overall survival rate in the study group were significantly higher than those in the control group(both P<0.05).The incidences of radiation proctitis and radiation cystitis in the study group were significantly lower than those in the control group(both P<0.05).Cox proportional hazards regression analysis showed that treatment method,parametrial infiltration depth,tumor size,and FIGO stage were independent influencing factors of PFS(all P<0.05).Conclusion Compared with conventional intracavitary brachytherapy,three-dimensional image-guided ¹⁹²Ir interstitial brachytherapy for LACC has better dosimetric parameters,higher short-term efficacy,and lower incidence of adverse reactions.
Keywords：locally advanced cervical carcinomapelvic intensity-modulated radiation therapythree-dimensional interstitial brachytherapy192Irradiation injuries
Publication Date：2025-12-25
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：5( 108-111,116 )