Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA.
Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD.
Brachytherapy. 2021 Sep-Oct;20(5):984-994. doi: 10.1016/j.brachy.2020.11.011. Epub 2021 Jan 19.
Intracavitary gynecologic brachytherapy in the form of tandem-based brachytherapy and vaginal cylinder-based brachytherapy represents a fundamental component of the treatment of women with cervical or uterine cancer due to the ability to deliver a therapeutic dose of radiation with sharp dose falloff. This results in highly effective treatment in terms of oncologic outcomes with an overall favorable toxicity profile. Still, complications and side effects of brachytherapy do exist. While advances in brachytherapy techniques have led to a significant decrease in the rates of toxicity, a thorough understanding of the potential complications is crucial to ensuring optimal outcomes for women with gynecologic cancer undergoing brachytherapy. Use of equivalent dose at 2 Gy per fraction (EQD2) models has allowed incorporation of external beam radiotherapy dose to the brachytherapy dose leading to development of consolidated dose constraints for organs-at-risk in the modern era. This manuscript offers a comprehensive review of potential complications associated with intracavitary brachytherapy for gynecologic cancer including predictive factors, mitigation tactics, and management strategies.
腔内妇科近距离放射治疗，包括基于施源器的近距离放射治疗和阴道圆柱型近距离放射治疗，是治疗宫颈癌或子宫癌的基本方法，因为它能够提供具有陡峭剂量跌落的治疗剂量的辐射。这在肿瘤学结果方面实现了非常有效的治疗，同时具有总体良好的毒性特征。尽管如此，近距离放射治疗确实存在并发症和副作用。虽然近距离放射治疗技术的进步导致毒性发生率显著降低，但为了确保接受近距离放射治疗的妇科癌症女性获得最佳结果，透彻了解潜在的并发症至关重要。使用等效剂量为 2 Gy/分数（EQD2）模型，将外部束放射治疗剂量纳入近距离放射治疗剂量，导致在现代时代制定了风险器官的综合剂量限制。本文全面回顾了妇科癌症腔内近距离放射治疗相关的潜在并发症，包括预测因素、缓解策略和管理策略。
