ABSTRACT
The purposes of this retrospective study were to analyze local control of squamous cell carcinoma of the cervix treated with computed tomography (CT)-based image-guided brachytherapy (IGBT), as well as the factors affecting local control. A total of 39 patients were analyzed. The prescribed dose to the pelvis was 45-50 Gy with or without central shielding (CS). IGBT was delivered in 1-5 fractions. The total dose for high-risk clinical target volume (HR-CTV) was calculated as the biologically equivalent dose in 2-Gy fractions. The median follow-up period was 29.3 months. The 2-year overall survival and local control rates were 97% and 91%, respectively. In univariate analysis, the dose covering 90% of the HR-CTV (D90) and tumor size were found to be significant factors for local control. The cutoff values of tumor size and D90 for local control were 4.3 cm (area under the curve [AUC] 0.75) and 67.7 Gy (AUC 0.84) in the CS group and 5.3 cm (AUC 0.75) and 73.7 Gy (AUC 0.78) in the group without CS, respectively. However, though the local control of CT-based IGBT was favorable, the results suggested that the dose required for tumor control may differ depending on the presence of CS.
Subject(s)
Brachytherapy/methods , Carcinoma, Squamous Cell/radiotherapy , Radiotherapy, Conformal/methods , Uterine Cervical Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Female , Humans , Imaging, Three-Dimensional , Middle Aged , Radiotherapy Dosage , Retrospective Studies , Tomography, X-Ray Computed , Uterine Cervical Neoplasms/pathologyABSTRACT
Percutaneous cryoablation for renal tumors may be associated with rare complications such as injury to the ureter. A 65-year-old woman underwent percutaneous cryoablation after a transcatheter arterial embolization using lipiodol and ethanol for left renal oncocytoma. Two months after the percutaneous cryoablation, computed tomography images showed left hydronephrosis caused by high-density debris, which was assumed to be sloughed tumor with lipiodol accumulation in the left ureter. A stent was placed in the left ureter to enhance the drainage of urine and the necrotic cell debris. Three months later, the ureteral stent was removed, and she remained asymptomatic during the follow-up period of 4 months. We should consider the possibility of urinary tract obstruction by sloughed tumor when hydronephrosis occurs after percutaneous cryoablation of a renal tumor.
