Interstitial Brachytherapy - Definitive and Adjuvant

Abstract

Gynecologic interstitial brachytherapy (ISBT) is the placement of catheters into and surrounding a tumor, with either a high-dose-rate (HDR) and low-dose-rate (LDR) technique. Using an HDR technique, the catheters are afterloaded with radioactive sources, the most common isotope being 192Ir. Brachytherapy (BT) is a key component in the treatment of gynecological cancers, as it allows for dose escalation to the tumor while minimizing the dose to surrounding critical organs at risk, such as the sigmoid, bladder, and rectum. Patterns of care studies established the essential role of BT in the management of cervical cancer and linked its use to improvements in pelvic control and disease-free survival. Furthermore, the use of image-guided BT shows improvement in pelvic control and disease-free survival based on a large review from the American Brachytherapy Cervical Cancer Task Force.