Background/ObjectivesTo evaluate the efficacy and safety of unique magnetic resonance imaging (MRI)-guided interstitial brachytherapy (ISBT) for locally advanced cervical cancer that is unsuitable for intracavitary brachytherapy (ICBT) or intracavitary/interstitial brachytherapy (ICISBT).Methods: We analyzed the clinical outcomes, including toxicity, of 68 previously untreated patients with cervical cancer treated between 2014 and 2024.Results: The median high-risk clinical target volume (HR-CTV) was 53.20 cc (range, 16.34–147.03 cc) with ISBT. With a median follow-up time of 37.5 months (7–115 months), the three-year local control, progression-free survival, and overall survival rates were 89.8%, 52.4%, and 70.9%, respectively. Multivariate analyses showed significant associations of histology with local control, overall treatment times, HR-CTV volume with overall survival rate, over all treatment times, and HR-CTV volume and M category with progression-free survival. Toxicity grade 3 occurred in 12 patients (17.6%) and consisted of four genitourinary (5.8%) and seven gastrointestinal (10.2%) toxicities.Conclusions: MRI-guided ISBT is an effective treatment strategy for obtaining a favorable local control rate for selected advanced diseases with an acceptable complication rate. Future research is warranted to elucidate who would be good candidates for MRI-guided ISBT.
背景/目的 评估磁共振成像（MRI）引导下组织间插植近距离治疗（ISBT）对于不适合腔内近距离治疗（ICBT）或腔内联合组织间插植近距离治疗（ICISBT）的局部晚期宫颈癌的疗效与安全性。 方法 本研究分析了2014年至2024年间接受治疗的68例初治宫颈癌患者的临床结局（包括毒性反应）。 结果 ISBT治疗的高危临床靶区（HR-CTV）中位体积为53.20 cc（范围：16.34–147.03 cc）。中位随访时间为37.5个月（7–115个月），三年局部控制率、无进展生存率和总生存率分别为89.8%、52.4%和70.9%。多变量分析显示：组织学类型与局部控制率显著相关；总治疗时间、HR-CTV体积与总生存率显著相关；总治疗时间、HR-CTV体积及M分期与无进展生存率显著相关。12例患者（17.6%）出现3级毒性反应，包括4例泌尿生殖系统毒性（5.8%）和7例胃肠道毒性（10.2%）。 结论 对于经过筛选的晚期宫颈癌患者，MRI引导的ISBT是一种有效的治疗策略，可获得良好的局部控制率且并发症发生率可接受。未来需进一步研究明确适合接受MRI引导ISBT治疗的患者特征。
MRI-Guided Multi-Catheter High-Dose-Rate Interstitial Brachytherapy for Uterine Cervical Cancer
肿瘤(癌症)患者之家