Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

Area of Science:

• Oncology
• Radiation Oncology
• Gynecologic Oncology

Background:

• Stereotactic body radiation therapy (SBRT) via helical tomotherapy (HT) is established for lung and liver tumors.
• Its use in locally advanced cervical cancer, particularly with uterine anomalies, remains unstudied.
• Brachytherapy is the standard, but anatomical challenges can limit its application.

Observation:

• A patient with FIGO stage IIIB cervical cancer and uterine myomas unsuitable for brachytherapy received concurrent chemoradiation therapy (CCRT) followed by SBRT via HT.
• The patient tolerated treatment with only grade 1 nausea and vomiting.
• Post-treatment, a hysterectomy revealed no tumor recurrence, with no significant toxicities noted at follow-up.

Findings:

• Concurrent chemoradiation therapy (CCRT) followed by SBRT via HT was an effective treatment for locally advanced cervical cancer in this case.
• The treatment was well-tolerated, with manageable side effects.
• No evidence of tumor recurrence was observed during follow-up.

Implications:

• SBRT via HT presents a viable alternative to brachytherapy for cervical cancer patients with complex uterine anatomy.
• This case highlights the potential safety and efficacy of SBRT in gynecologic oncology.
• Larger clinical trials are needed to confirm these findings and establish SBRT via HT as a standard treatment option.