Comparison of differences in hematogenous metastasis among cervical cancer patients by CT-guided three-tube intracavitary brachytherapy and hybrid intracavitary and interstitial brachytherapy.

OBJECTIVE

To compare whether CT-guided three-tube intracavitary brachytherapy (ICBT) and hybrid intracavitary with interstitial brachytherapy (IC/ISBT) will cause differences in the hematogenous metastasis of cervical cancer.

METHODS

A retrospective cohort study was conducted to analyze 224 patients in our hospital with FIGO stage Ib-IVa cervical cancer whose complete data were available for CT-guided brachytherapy between January 2020 and June 2021. A total of 110 (49.1%) patients were treated with ICBT, and 114 (50.9%) patients were treated with IC/ISBT. These patients were matched for age, histopathological type and grade, FIGO stage, lymph node metastasis status, total radiation dose, radiation dose in the lymph nodes, tumor size before brachytherapy and chemotherapy status. The number of hematogenous metastases that occurred within 2 years after the end of treatment was compared between the two groups.

RESULTS

There was no significant difference in the number of patients with hematogenous metastases between the ICBT group (n = 5, 4.5%) and the IC/ISBT group (n = 12, 10.5%) (P = 0.091), but there were significant differences in tumor size (P < 0.001), histopathological type (P = 0.023) and lymph node radiation dose (P = 0.006) before brachytherapy between the two groups. By propensity score matching (PSM) between the two groups according to 1:1 matching, single factor logistic regression analysis revealed that there was no significant difference in the incidence of hematogenous metastasis between the two groups (OR = 0.382, 95% CI = 0.071-2.040; P = 0.260).

CONCLUSION

CT-guided ICBT and IC/ISBT do not cause differences in hematogenous metastasis.