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High dose ratio (HDR) cervical ring applicator to control bleeding from cervical carcinoma
Perry W Grigsby1, L Portelance, J F Williamson
1Radiation Oncology Center, Mallinckrodt Institute of Radiology, Box 8224-21, Washington University School of Medicine, 4939 Children's Place-Suite 5500, St. Louis, Missouri 63110, USA. grigsby@netscape.net
Summary
High-dose rate (HDR) cervical brachytherapy effectively controlled acute vaginal bleeding in uterine cervical cancer patients. This treatment demonstrated a 93% success rate with no significant long-term toxicity.
Area of Science:
- Gynecologic Oncology
- Radiation Oncology
- Brachytherapy
Background:
- Acute vaginal bleeding is a serious complication of invasive cervical cancer.
- Transfusions are often required to manage severe hemorrhage.
- Effective and safe treatment options are crucial for patient care.
Purpose of the Study:
- To evaluate the efficacy of high-dose rate (HDR) cervical ring applicators in controlling acute vaginal bleeding.
- To assess the safety and toxicity profile of this HDR brachytherapy approach.
Main Methods:
- A study of 15 patients with invasive cervical cancer and acute vaginal bleeding.
- Two fractions of 5 Gy each, delivered weekly using an HDR intracavitary vaginal ring applicator (total 10 Gy).
- Diagnostic imaging and external irradiation initiated between fractions.
Main Results:
- Vaginal bleeding control was achieved in 93% (14/15) of patients without further transfusions.
- No acute or long-term Grade 3, 4, or 5 bowel or bladder toxicities were observed.
Conclusions:
- HDR cervical ring brachytherapy is an effective method for controlling acute vaginal bleeding in cervical cancer.
- The treatment is well-tolerated, with a favorable safety profile regarding acute and long-term toxicities.