Onkologie. 2025:19(1):25-28 | DOI: 10.36290/xon.2025.006

Interstitial brachytherapy in the treatment of uterine cervical cancer

Igor Sirák¹, Denisa Pohanková¹, Miroslav Hodek¹, Petr Paluska¹, Linda Kašaová¹, Jakub Grepl¹, Munachiso Onyedikachi Ndukwe², Ivan Práznovec², Martin Kopeček³, Petra Bretová², Jiří Petera¹

¹ Klinika onkologie a radioterapie, FN Hradec Králové

² Porodnická a gynekologická klinika FN, Hradec Králové

³ Ústav lékařské biofyziky, Lékařská fakulta v Hradci Králové

The standard treatment for locally or regionally advanced cervical cancer is definitive chemoradiotherapy, which combines systemic cisplatin chemotherapy with external-beam radiotherapy followed by intracavitary, so-called uterovaginal brachytherapy. The current standard of brachytherapy for cervical cancer is MR-guided 4D-adaptive brachytherapy. Thanks to MR navigation, the current extent of residual tumor involvement and the coverage of target volumes by intracavitary application into the uterus is visible during each brachytherapy fraction. In more than a third of patients, however, it is impossible to cover the target structures with a therapeutic dose of radiation due to the extent of the disease, without observing safe dose limits for the surrounding healthy tissues simultaneously. The ideal solution to such a situation is to use the interstitial application of needles in places not covered by the pure intracavitary application. The standard supplied applicators for uterovaginal brachytherapy usually allow interstitial application or 3D-printed or modified applicators can be used for the application of interstitial needles. This article aims to show the practical procedure of using interstitial brachytherapy in the treatment of cervical cancer at the University Hospital in Hradec Králové.

Keywords: uterine cervix carcinoma, radiotherapy, brachytherapy, interstitial, magnetic resonance.

Accepted: February 27, 2025; Published: March 10, 2025  Show citation