Jiang Ping, Zou Lijuan, Wei Lichun, Cheng Guanghui, Sun Baosheng, Zhang Fuquan, Wang Ruoyu, Wang Tiejun, Qu Ang, Yuan Xiangkun, Qiu Bin, Wei Shuhua, Liu Zi, Zhang Yunyan, Wang Junjie
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
Department Radiation Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Oncol. 2021 Nov 9;11:700710. doi: 10.3389/fonc.2021.700710. eCollection 2021.
The treatment modality for recurrent cervical cancer (rCC) is limited, and the prognosis of these patients is poor. Seed implantation could be an important component of rCC management in the context of dose boost or salvage therapy after surgery or radiotherapy, which is characterized by a minimally invasive, high local dose, and rapidly does fall, sparing normal tissue. For patients with good performance status and lateral pelvic wall recurrence with an available puncture path, seed implantation was recommended, as well as for selected central pelvic recurrence and extra-pelvic recurrence. The combination of brachytherapy treatment planning system and CT guidance was needed, and three-dimensional printing templates could greatly improve the accuracy, efficiency, and quality of seed implantation to achieve a potential ablative effect and provide an efficient treatment for rCC. However, the recommendations of seed implantation were mainly based on retrospective articles and lack high-quality evidence, and multicenter prospective randomized studies are needed. In this consensus on iodine seed implantation for rCC, indication selection, technical process and requirements, dosimetry criteria, radiation protection, combined systemic therapy, and outcomes of seed implantation for rCC are discussed.
复发性宫颈癌（rCC）的治疗方式有限，这些患者的预后较差。在手术或放疗后的剂量增强或挽救治疗中，粒子植入可能是rCC治疗的重要组成部分，其特点是微创、局部剂量高且剂量迅速下降，可保护正常组织。对于身体状况良好且有可用穿刺路径的侧盆腔壁复发患者，以及部分中央盆腔复发和盆腔外复发患者，建议进行粒子植入。需要近距离放射治疗计划系统与CT引导相结合，三维打印模板可大大提高粒子植入的准确性、效率和质量，以实现潜在的消融效果并为rCC提供有效的治疗。然而，粒子植入的建议主要基于回顾性文章，缺乏高质量证据，需要多中心前瞻性随机研究。在这份关于rCC碘粒子植入的共识中，讨论了rCC粒子植入的适应证选择、技术流程和要求、剂量学标准、辐射防护、联合全身治疗以及粒子植入的结果。
