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Brachytherapy is an essential component of treatment for cervical
cancer, offering real advantages over other cervical cancer treatment
options in terms of survival rates and side effects. Depending on the
tumor stage, it can be performed with intracavitary or combined
intracavitary/interstitial technique. On the basis of high-level
evidence from randomized controlled trials, brachytherapy is indicated
as standard in combination with chemoradiation in patients with locally
advanced cervical cancer (LACC).
Brachytherapy can be used alone in some cases of early-stage cervical
cancers.
Procedure
What is the brachytherapy procedure for cervical cancer?
Intracavitary brachytherapy is placed into the vagina (open cavity),
close to the cervix uteri. Small radioactive sources precisely deliver
radiation through an applicator and are completely removed after
delivery, so no radioactivity will remain in the patients’ body.
Modern brachytherapy uses Magnetic Resonance Imaging (MRI) or Computed
Tomography (CT) images to control the position of the tumor and the
radioactive source. Elekta offers
Elekta Studio*,
featuring the ImaginRing, that enables imaging through all the steps
of the flow without moving the patient.
*Elekta is the authorized Exclusive Distributor of medPhoton in
Brachytherapy. ImagingRing is product manufactured by medPhoton
GmbH. ImagingRing may not be available in all markets.
Applicators
Brachytherapy applicators for the treatment of cervical cancer
Choosing the right applicator for brachytherapy in cervical cancer
treatment is a crucial decision. Diagnostic imaging serves as a
guiding beacon in the selection of brachytherapy applicators for
cervical cancer treatment. With the help of CT and MRI the most
suitable applicator is chosen to align with the unique needs of each
individual, ensuring precise and personalized treatment delivery.
Elekta offers the broadest range of CT/MR compatible applicators for
gynecological brachytherapy. Our diverse selection of applicators
caters to a wide spectrum of applications, from intracavitary to
interstitial use, designed to elevate the standard of care in
gynecologic brachytherapy.
How successful is brachytherapy for cervical cancer?
A large-scale study compared treatment outcomes with and without
brachytherapy, revealing a remarkable advantage in 5-year survival
rates for patients who received brachytherapy. This vital study
underscores the potential of brachytherapy in patients to defy the
odds and live longer, healthier lives. When brachytherapy was
incorporated into the treatment plan, patients experienced a clear
advantage in 5-year survival rates. A significant percentage
difference emerged, with a 54% survival rate for those who received
brachytherapy, compared to a comparatively lower rate of 42% for
those without it. These results exemplify the profound impact that
brachytherapy can have on the lives of individuals battling cervical
cancer. (see picture 1).2
This study was carried out before the era of Image-guided
brachytherapy, yet it still yielded notable improvements in survival
rates.
Picture 1. Overall survival in patients with cervical cancer
treated with brachytherapy and without brachytherapy2
Image-guided brachytherapy represents a significant leap forward in
treatment precision and patient outcomes. A study from the
Netherlands showcased a substantial difference in overall survival
rates between conventional 2D brachytherapy and image-guided
brachytherapy. The image-guided approach demonstrated a far-reaching
impact, with overall survival rates reaching an impressive 86% for
image-guided brachytherapy, compared to 51% with conventional
methods. (see picture 2).3 This is due to brachytherapy
under CT - or MRI-guidance is more precise as it targets the tumor
but spares surrounding healthy tissues and organs.
Picture 2. Overall survival in patients with cervical cancer
treated with conventional brachytherapy and image-guided
brachytherapy3
The international EMBRACE I study which included 1341 patients with
cervical cancer, showed MRI-guided brachytherapy as a powerful tool,
ensuring an astounding 92% rate of local control at 5 years across
all stages.
For women with stage 1B1 cervical cancer, the local control rate
soared even higher, reaching an exceptional 98%. (see picture
3).4
This highlights the potential of early diagnosis and incorporating
MRI-guided brachytherapy into treatment plans.
Picture 3. Local control in patients with cervical cancer (data
from the EMBRACE I study).
References
1. Banerjee R et al. Int J Womens Health. 2014 Sep;6:555-64.
Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045176/pdf/ijwh-6-555.pdf
Accessed June 2021
2. Han K et al. Int J Radiat Oncol Biol Phys. 2013 Sep
1;87(1):111-9. Available at:
https://www.redjournal.org/article/S0360-3016(13)00595-6/fulltext
Accessed June 2021
3. Rijkmans EC et al. Gyn Oncol. 2014 Aug 26;135(2):231-8.
Available at:
https://www.gynecologiconcology-online.net/article/S0090-8258(14)01280-3/fulltext
Accessed June 2021
4. Poetter R et al. The Lancet Oncol 2021 April 1;22(4):538-47.
Available at: https://doi.org/10.1016/S1470-2045(20)30753-1
Accessed June 2021
Testimonials
What our customers say
The voice of our customers speaks volumes about the impact our
technology has on patient lives and treatment outcomes. Dr. Spencer
Thompson from the University of Oklahoma highlights the significance
of Elekta's gynecological brachytherapy in transforming patient
care. Dr. Sabhakar Mutyala from the University of Arizona emphasizes
the efficacy of our breast brachytherapy solutions. Their
testimonials not only validate our efforts but also inspire us to
continue building hope and delivering the best possible cancer care.
Spencer Thompson, MD at University of Oklahoma, on Gynecological
Brachytherapy
Sabhakar Mutyala, MD from University of Arizona, on Breast
Brachytherapy
Other indications
Other indications
Find out about our Brachytherapy solutions for other indications.