High dose rate (HDR) cervical ring applicator to control bleeding from cervical carcinoma

Grigsby, P.W.; Portelance, Lise; Williamson, Jeffrey F.

doi:10.1136/ijgc-00009577-200201000-00003

Cited by 12 publications

(9 citation statements)

References 9 publications

(16 reference statements)

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“…There were two failures: one local failure and another distant combined with local failure (5) . For the treatment of hemorrhagic carcinoma of the uterine cervix, hemostatic radiotherapy is effective in controlling acute vaginal bleeding and can be delivered without undue acute or long‐term toxicity (2,3) . The current case demonstrated that radiation therapy can effectively control the vaginal bleeding from metastatic vaginal ASPS.…”

Section: Discussionmentioning

confidence: 71%

“…Radiation therapy can control vaginal bleeding by rapidly shrinking the tumor and sealing the oozing vasculature by fibrosis. Both external and intracavitary radiotherapy have been used for control of vaginal bleeding from uterine cervical cancer (2,3) . However, it is not well known whether radiation therapy can effectively control vaginal bleeding from a sarcoma of the female genital tract, especially from vaginal ASPS.…”

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confidence: 99%

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A case of alveolar soft part sarcoma with vaginal metastasis: successful control of vaginal bleeding with external beam irradiation

Park

Huh

Han

et al. 2005

Int J Gynecol Cancer

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Alveolar soft part sarcoma (ASPS) of the vagina is an exceptionally rare neoplasm. Furthermore, vaginal metastasis of ASPS has not been reported. A 28-year-old woman with a history of a right thigh mass diagnosed as ASPS excised 8 years ago presented to the emergency room with massive vaginal bleeding and anemia. Biopsy of a vaginal mass revealed that the tumor was a vaginal metastasis of ASPS. For control of intractable bleeding and preventing further transfusions, palliative radiation therapy was planned. She received a total of 39 Gy (daily 3 Gy, using 15-MV photons), and after 6-Gy irradiation, there was no more vaginal bleeding and no more transfusion needed. This is the first case of vaginal metastasis of ASPS reported in the literature that was manifested by intractable vaginal bleeding, which was controlled successfully with radiation therapy.

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Section: Discussionmentioning

confidence: 71%

mentioning

confidence: 99%

A case of alveolar soft part sarcoma with vaginal metastasis: successful control of vaginal bleeding with external beam irradiation

Park

Huh

Han

et al. 2005

Int J Gynecol Cancer

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Section: Introductionmentioning

confidence: 99%

“…This approach allows a majority of patients to proceed with subsequent external beam radiation therapy and even transition to curative treatment with long-term survival benefits due to favorable treatment outcomes. [7,8] A systematic review and meta-analysis investigated the efficacy and toxic reactions of palliative radiation therapy in terms of pain relief and bleeding control in patients with advanced cervical cancer. The study summarized the hemostatic efficacy of high-dose-rate radiation therapy, whether delivered through external stereotactic body radiation therapy or ICBT.…”

Section: Introductionmentioning

confidence: 99%

Observation of hemostatic effectiveness and safety of ultrasound-CT guided 3D intracavitary and interstitial brachytherapy in the treatment of larger cervical cancer with bleeding: A retrospective study

Hu,

Jin,

Wang

et al. 2023

Medicine

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Cervical cancer is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women. This study explored the effectiveness and safety of ultrasound-CT guided 3D intracavitary and interstitial brachytherapy (US-CT-3D-IGBT) in the treatment of larger cervical cancer with bleeding. A retrospective study was conducted on 31 patients with larger cervical squamous cell carcinoma (tumor short diameter >4 cm) with vaginal bleeding. US-CT-3D-IGBT was used to deliver a single high-dose prescription of high-risk clinical target volume (HR-CTV) 1000 to 1200 centigray (cGy) to the cervical tumor, followed by conventional intensity-modulated radiation therapy (IMRT) synchronous chemoradiotherapy (45–50 gray (Gy)/25–28 fraction(f)) with weekly cisplatin 25 mg/m2. After external radiotherapy, simple intracavitary brachytherapy (BT) combined with manual interstitial BT was administered at 30 Gy/5F or 28 Gy/4F. Within 24 hours after high-dose 3D-IGBT, bleeding stopped in 2 patients (6.4%), and bleeding was reduced in a total of 11 patients (35.4%) within 48 hours. A total of 29 patients achieved hemostasis within 72 hours, with an effective rate of 93.5%. The remaining 2 patients reached the clinical hemostasis requirement on the 4th and 5th day. All patients experienced a significant reduction in vaginal bleeding after the initial BT, with an average reduction of 66 mL (160–20 mL). US-CT-3D-IGBT is effective in rapidly controlling bleeding in patients with larger cervical cancer (tumor short diameter >4 cm), and the treatment is relatively safe and feasible.

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“…We read with great interest the article High dose rate (HDR) cervical ring applicator to control bleeding from cervical carcinoma by Grisgby et al . ( 1 ) The authors have addressed the use of HDR brachytherapy, in probably the first report in the literature, to control the bleeding from cervical cancer. The problem of vaginal bleeding requiring hemostatic radiotherapy is more frequently encountered in developing countries where the majority of cervical cancer patients present with bulky advanced diseases.…”

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confidence: 99%