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Published on: February 10, 2023
Good safety of oblique needle insertion using the Venezia applicator for cervical cancer: A single-center cohort
Jean-François Py1, Sophie Renard1, William Gehin1
1Academic Department of Radiation Therapy & Brachytherapy, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France.
Purpose:
To evaluate procedural complications associated with the use of the Venezia applicator with oblique needles for treating locally advanced cervical cancer (LACC).
Methods:
We conducted a retrospective analysis of 30 patients treated at our center between November 2019 and August 2024 using the Venezia applicator. All patients underwent combined intracavitary and interstitial brachytherapy with oblique needle implantation. Procedural complications were classified using the Clavien-Dindo classification, focusing on organ perforations and bleeding events.
Results:
The median age was 54.5 years. Most patients (90%) had squamous cell carcinoma, and the predominant stage FIGO was T3b (46.7%). The median HR-CTV volume was 32.8cc [24.5-39.3] and the median HR-CTV D90 was 86.0 Gy [82.7-90.5]. All organ at risk dose constraints were respected. Oblique needle perforation occurred in 7/30 patients (23.3%) and in 16/130 needles (12.3%), most often in the bladder. The majority (96.7%) experienced no or mild complications (grade 0-1). The most common complication was minor bleeding during applicator removal, controlled with manual compression. One patient experienced grade 2 bleeding requiring transfusion. No grade 3-5 complications were observed.
Conclusion:
The use of the Venezia applicator with oblique needles for locally advanced cervical cancer (LACC) appears safe and feasible, with a low rate of significant complications. Oblique needle insertion facilitates distal parametrial coverage, making it a valuable tool for challenging tumor extensions.
