Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, CA.
Department of Obstetrics and Gynecology, University of California Los Angeles, Los Angeles, CA.
Brachytherapy. 2024 May-Jun;23(3):266-273. doi: 10.1016/j.brachy.2023.12.007. Epub 2024 Mar 6.
Treatment of recurrent oligometastatic gynecologic malignancy may involve targeted surgery, thermal ablation, or CT-guided high-dose-rate interstitial brachytherapy ablation (CT-HDR-IBTA). The purpose of this study was to describe the safety and efficacy of CT-HDR-IBTA for oligometastatic gynecologic malignancies.
With institutional review board approval (IRB) approval and compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliance, we searched our database to assemble a single-arm study cohort of all patients with oligometastatic gynecologic cancers who underwent CT-HDR-IBTA from 2012-2022 with follow-up. The electronic record was reviewed to determine relevant clinicopathological variables including patient demographics, prior treatments, clinical course, local control, and local and distant recurrence with follow-up imaging.
The study cohort comprised 37 lesions in 34 patients treated with CT-HDR-IBTA for recurrent oligometastatic uterine (n = 17), cervix (n = 1), or ovarian cancer (n = 16) with an average lesion size of 2.5 cm with an average patient age of 61.4 years. Each lesion was treated with an average radiation dose of 23.8 Gy in 1.8 fractions and a median follow-up time of 24.0 months. The primary efficacy of CT HDR ITBA was 73% with a median progression-free survival of 8.0 months (95% CI 3.6-12.8 months) and with 58% of patients still alive at 43 months with median overall survival not reached. The rate of Grade 1 adverse events was 22% without any Grade 2, 3 or 4 events.
CT HDR IBTA was safe and effective for treating oligometastatic gynecologic cancers in a heavily pretreated cohort.
复发性寡转移妇科恶性肿瘤的治疗可能涉及靶向手术、热消融或 CT 引导下高剂量率间质近距离放疗消融（CT-HDR-IBTA）。本研究的目的是描述 CT-HDR-IBTA 治疗寡转移妇科恶性肿瘤的安全性和有效性。
在机构审查委员会（IRB）批准和遵守 1996 年健康保险流通与责任法案（HIPAA）的规定下，我们搜索了数据库，收集了 2012 年至 2022 年间接受 CT-HDR-IBTA 治疗且有随访的寡转移妇科癌症患者的单臂研究队列。审查电子记录以确定相关临床病理变量，包括患者人口统计学、既往治疗、临床过程、局部控制以及随访影像学显示的局部和远处复发。
研究队列包括 34 名患者的 37 个病灶，这些患者因复发性寡转移子宫（n=17）、宫颈（n=1）或卵巢癌（n=16）接受 CT-HDR-IBTA 治疗，平均病灶大小为 2.5 厘米，平均患者年龄为 61.4 岁。每个病灶接受平均 23.8 Gy 的放射剂量，分 1.8 个部分进行治疗，中位随访时间为 24.0 个月。CT-HDR-IBTA 的主要疗效为 73%，中位无进展生存期为 8.0 个月（95%CI：3.6-12.8 个月），43 个月时仍有 58%的患者存活，中位总生存期未达到。1 级不良事件发生率为 22%，无 2、3 或 4 级事件。
CT-HDR-IBTA 在治疗预处理后重度的寡转移妇科癌症患者中是安全且有效的。
