Tough on Cancer, Gentle on the Woman

Cervical cancer treated with image guided brachytherapy results in few serious side effects

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Cervical cancer that’s caught early is very treatable and often curable. Treatment may include a combination of surgery, radiation therapy and chemotherapy. Two large studies have zeroed in on a particular type of radiotherapy.

Brachytherapy places radioactive beads near the tumor. Recent studies have found that high-dose brachytherapy is effective for treating cervical cancer, with very few serious side effects.

This procedure was found to stop tumor growth in about 90 percent of patients.

"Learn about the type of radiation therapy you’ll be receiving."

Conventional radiation therapy beams high energy X-rays to the cancer site. This is called external beam radiation.

With this type of therapy, the vagina receives high levels of radiation that can cause a number of symptoms (morbidity).

Following radiation, cervical cancer survivors can experience vaginal dryness, inflammation and bleeding along with a narrowing and shortening of the canal. The colon and bladder can also be affected.

Image-guided brachytherapy uses either magnetic resonance imaging (MRI) or computed tomography (CT) to place the radioactive material near the tumor.

Kathrin Kirchheiner, MSc, a PhD student in the Department of Radiotherapy at the Medical University Vienna in Austria, reported on the clinical trial EMBRACE at the European Society for Radiotherapy and Oncology (ESTRO). EMBRACE is a European and international study on MRI-guided brachytherapy in locally advanced cervical cancer.

The study involved 523 patients who were followed for a median of 14 months. The women had locally advanced cervical cancer, meaning it had started to spread to nearby tissues and lymph nodes.

Study members had undergone external beam radiotherapy, chemotherapy and MRI-guided brachytherapy.

Researchers looked at the effects of the treatment on the vagina at the start of therapy, every three months for the first year, biannually during the second and third year, and annually thereafter.

MRI was used to assess how much radiation was going into the upper part of the vaginal wall.

"Our results show that severe vaginal side effects are rare," said Kirchheiner in a press release.

The most common effects from the therapy were shortening and narrowing of the upper vagina.

While serious side effects were quite low, 78 percent of the women experienced mild to moderate vaginal problems in the first year after treatment, and 92 percent had vaginal morbidity two years after the treatment ended.

This therapy can be customized to treat the specific characteristics of the tumor, she suggested.

“Brachytherapy is an essential part of the curative treatment of locally advanced cervical cancer, because of the high dose that can be delivered to the tumor while sparing organs at risk of damage from the treatment,” Kirechheiner concluded.

Nearly 12,500 women in the US will be diagnosed with cervical cancer this year, which causes 4,000 deaths every year.

All research is considered preliminary before it is published in a peer-reviewed journal. No study funding or conflict of interest information was provided.

Reviewed by: 
Review Date: 
April 22, 2013
Last Updated:
November 21, 2013