High-dose-rate brachytherapy for XXXX : learning from treatment complications.

@entity5 @entity1 @entity137 @entity1168
Historically, early stage @entity5 has been treated with low-dose-rate (LDR) brachytherapy with or without external beam radiation therapy (EBRT). Complication rates have been low and treatment efficacious. Although @entity1168 ( @entity1168 ) brachytherapy has been used for cervical @entity5 in many countries for over a decade, only more recently has it been integrated into treatment plans for @entity5 . This paper describes three @entity1 treated with @entity1168 brachytherapy who experienced significant late effects. Given the very limited amount of literature regarding the use of @entity1168 brachytherapy in @entity5 , this analysis potentially contributes to an understanding of treatment-related risk factors for complications among @entity1 treated with this modality.A focused review of hospital and departmental treatment records was done on three @entity1 treated with @entity1168 brachytherapy. Abstracted information included clinical data, treatment parameters (technique, doses, volume, combinations with other treatments) and outcomes (local control, survival, early and late effects). A review of the available literature was also undertaken. All @entity1 had significant complications. Although statistical correlations between treatment parameters and complications are impossible given the limited number of @entity1 , this descriptive analysis suggests that vaginal length treated with @entity1168 brachytherapy is a risk factor for early and late effects, that the distal vagina has a lower radiation tolerance than the upper vagina with @entity1168 as in LDR, and that combining @entity1168 with LDR as done in our experience carries a high risk of late @entity137 . Integration of @entity1168 brachytherapy techniques into treatment plans for early stage @entity5 must be done cautiously. The etiology of the significant side effects seen here is likely to be multifactorial. For users of @entity1168 brachytherapy in @entity5 , there is a need to further refine and standardize treatment concepts and treatment delivery. Ideally this will be based on continued careful observation and reporting of both favorable and unfavorable outcomes and experiences.
