Pellizzon Antonio Cássio Assis
Department of Radiation Oncology, AC Camargo Cancer Center, Sao Paulo, Brazil.
J Contemp Brachytherapy. 2018 Dec;10(6):567-569. doi: 10.5114/jcb.2018.81027. Epub 2018 Dec 28.
Cervical cancer (CC) is a neoplasm with great potential for prevention, but it is still an important public health problem in most developing countries. No significant difference is found in the literature between intracavitary high-dose-rate (HDR) and low-dose-rate (LDR) brachytherapy, when considering overall, disease specific, and recurrence-free survivals. Cervical dilatation is mandatory for the insertion of intra-uterine tandems for CC intracavitary brachytherapy. Pain and discomfort may eventually be the limiting factors of the procedure, sometimes leading to unsatisfactory results in terms of adequate position of the applicator set. In this paper, we critically reviewed the current sedation and anesthetic options for comfort and safety procedures when performing intracavitary brachytherapy.
宫颈癌(CC)是一种具有很大预防潜力的肿瘤,但在大多数发展中国家,它仍然是一个重要的公共卫生问题。在总体生存率、疾病特异性生存率和无复发生存率方面,文献中未发现腔内高剂量率(HDR)近距离放疗和低剂量率(LDR)近距离放疗之间存在显著差异。对于宫颈癌腔内近距离放疗中子宫施源器的插入,宫颈扩张是必不可少的。疼痛和不适最终可能成为该操作的限制因素,有时会导致施源器放置位置不理想,从而影响治疗效果。在本文中,我们批判性地回顾了当前在进行腔内近距离放疗时用于舒适和安全操作的镇静和麻醉选择。