Research progress on brachytherapy for recurrent cervical cancer / 中华放射肿瘤学杂志

ABSTRACT

Cervical cancer is a common malignancy in women. Surgery and radiotherapy are the main therapeutic approaches. The recurrence rate of cervical cancer is high and the prognosis is relatively poor. Recurrent cervical cancer can be classified into the central pelvic, lateral pelvic and extra-pelvic recurrence. The management of recurrent cervical cancer mainly depends on previous therapeutic approaches and the recurrence site. Surgical resection is the optimal option for patients who have no history of radiotherapy, if feasible, chemoradiotherapy±brachytherapy can be considered. Patients with central pelvic recurrence after radiotherapy are suitable candidates for pelvic exenteration±intraoperative radiotherapy. However, the indications are highly selective, the incidence of postoperative complications is high and the quality of life is poor. Patients with lateral pelvic recurrence after radiotherapy could be treated by re-radiotherapy or chemotherapy. However, the incidence of serious side effects of re-radiotherapy is higher than that of the initial radiotherapy. The indications for stereotactic body radiotherapy are limited and the surgical skill of the surgeons is demanding. In recent years, radiotherapy technology has become more precise. Image-guided brachytherapy, such as high-dose-rate interstitial brachytherapy and radioactive 125I seed implantation, has achieved high efficacy and safety, which may provide new treatment options for recurrent cervical cancer. In this article, research progress on brachytherapy for recurrent cervical cancer was summarized and reviewed.