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Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
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Ureteral stent insertion for gynecologic interstitial high-dose-rate brachytherapy
D Jeffrey Demanes1, Robyn Banerjee1, Benjamin L Cahan1
1Division of Brachytherapy, Department of Radiation Oncology, David Geffen UCLA School of Medicine, Los Angeles, CA.
Brachytherapy
|January 6, 2015
Summary
Placing ureteral stents during gynecologic brachytherapy significantly reduced ureteral strictures. This technique allows for better dosimetry and protects ureters as organs at risk, improving patient outcomes.
Area of Science:
- Gynecologic Oncology
- Radiation Oncology
- Urology
Background:
- Interstitial brachytherapy is a crucial treatment for cervical cancer.
- Ureteral strictures are a potential complication of brachytherapy.
- Optimizing radiation delivery while minimizing toxicity to surrounding organs is essential.
Purpose of the Study:
- To evaluate the effectiveness of ureteral stents in preventing benign ureteral strictures after high-dose-rate interstitial brachytherapy for cervical cancer.
- To assess the impact of ureteral stenting on dosimetry and dose constraints.
Main Methods:
- Retrospective review of 289 cervical cancer patients treated with high-dose-rate interstitial brachytherapy without prior hydronephrosis.
- Comparative dosimetry analysis in five cases with and without ureteral stents and dose constraints.
- Three dosimetry plans were created to evaluate the impact of ureteral contouring and dose constraints.
Main Results:
- Zero ureteral strictures were observed in 34 stented cases, compared to 11 strictures in 255 nonstented cases.
- Ureteral dose constraints, when applied with stenting, significantly reduced radiation dose to the ureters (median 22-30.9% reduction).
- Stenting facilitated the identification and protection of ureters as organs at risk.
Conclusions:
- Temporary ureteral stents are effective in preventing ureteral obstruction during interstitial gynecologic brachytherapy.
- Stenting and the application of ureteral dose constraints improve dosimetry and reduce radiation exposure to the ureters.
- This approach enhances the safety profile of brachytherapy for cervical cancer patients.
Keywords:
BrachytherapyCervix cancerEndometrial cancerGynecologic malignancyHDRHigh-dose-rateInterstitialStrictureUreterUreteral stentMore Related Videos
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