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High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report

In order to improve oncologic outcomes in radiotherapy treatments of patients with unresectable pelvic sidewall recurrences of uterine cervical cancer, we combined high-dose-rate interstitial brachytherapy (HDR-ISBT) with newly tested hypoxic radiosensitizer Kochi oxydol-radiation therapy for unrese...

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Autores principales: Nakata, Mio, Yoshida, Ken, Shimbo, Taiju, Yoshikawa, Nobuhiko, Yoshioka, Hiroto, Hori, Akihiro, Sato, Chikara, Uesugi, Yasuo, Kogata, Yuhei, Masui, Koji, Murakami, Naoya, Kashihara, Tairo, Akiyama, Hironori, Tselis, Nikolaos, Ohmichi, Masahide, Nihei, Keiji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787211/
https://www.ncbi.nlm.nih.gov/pubmed/33437310
http://dx.doi.org/10.5114/jcb.2020.101695
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author Nakata, Mio
Yoshida, Ken
Shimbo, Taiju
Yoshikawa, Nobuhiko
Yoshioka, Hiroto
Hori, Akihiro
Sato, Chikara
Uesugi, Yasuo
Kogata, Yuhei
Masui, Koji
Murakami, Naoya
Kashihara, Tairo
Akiyama, Hironori
Tselis, Nikolaos
Ohmichi, Masahide
Nihei, Keiji
author_facet Nakata, Mio
Yoshida, Ken
Shimbo, Taiju
Yoshikawa, Nobuhiko
Yoshioka, Hiroto
Hori, Akihiro
Sato, Chikara
Uesugi, Yasuo
Kogata, Yuhei
Masui, Koji
Murakami, Naoya
Kashihara, Tairo
Akiyama, Hironori
Tselis, Nikolaos
Ohmichi, Masahide
Nihei, Keiji
author_sort Nakata, Mio
collection PubMed
description In order to improve oncologic outcomes in radiotherapy treatments of patients with unresectable pelvic sidewall recurrences of uterine cervical cancer, we combined high-dose-rate interstitial brachytherapy (HDR-ISBT) with newly tested hypoxic radiosensitizer Kochi oxydol-radiation therapy for unresectable carcinomas (KORTUC II), an enzyme-targeting radiosensitization treatment involving intra-tumoral injection of sodium hyaluronate mixed with hydrogen peroxide. We report on a 63-year-old patient referred to our department with an extensive pelvic sidewall recurrence of uterine cervical cancer after initial hysterectomy. The tumor size was 55 × 25 × 80 mm, with a calculated volume of 89.7 cc. Whole pelvic irradiation of 50 Gy in 25 fractions was administered, combined with weekly cisplatin injections. KORTUC II injections were given two times: at day 21 (42 Gy) and at day 24 (48 Gy). After finishing whole pelvic irradiation, HDR-ISBT of 25 Gy in 5 fractions b.i.d. over 3 days was administered. KORTUC II was also injected at the time of implantation. Dose-volume histogram (DVH) values for clinical target volume were D(90), D(98), and D(100) of 6.0, 5.0, and 3.5 Gy per fraction, respectively. D(2cc) values were 2.1, 4.1, 3.2, and 2.0 Gy per fraction for the bladder, rectum, sigmoid colon, and small bowel, respectively. No acute adverse events ≥ grade 3 were observed. Repeated grade 3 pyelonephritis occurred as a late complication at 11, 24, and 26 months after the treatment, and was successfully resolved with antibiotics. Moreover, grade 2 late toxicity was documented, including sciatic neuralgia, lower limb lymphedema, and urinary incontinence. At present, 32 months after HDR-ISBT, the patient remains free of disease, with no toxicity-related deterioration in physical condition.
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spelling pubmed-77872112021-01-11 High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report Nakata, Mio Yoshida, Ken Shimbo, Taiju Yoshikawa, Nobuhiko Yoshioka, Hiroto Hori, Akihiro Sato, Chikara Uesugi, Yasuo Kogata, Yuhei Masui, Koji Murakami, Naoya Kashihara, Tairo Akiyama, Hironori Tselis, Nikolaos Ohmichi, Masahide Nihei, Keiji J Contemp Brachytherapy Case Report In order to improve oncologic outcomes in radiotherapy treatments of patients with unresectable pelvic sidewall recurrences of uterine cervical cancer, we combined high-dose-rate interstitial brachytherapy (HDR-ISBT) with newly tested hypoxic radiosensitizer Kochi oxydol-radiation therapy for unresectable carcinomas (KORTUC II), an enzyme-targeting radiosensitization treatment involving intra-tumoral injection of sodium hyaluronate mixed with hydrogen peroxide. We report on a 63-year-old patient referred to our department with an extensive pelvic sidewall recurrence of uterine cervical cancer after initial hysterectomy. The tumor size was 55 × 25 × 80 mm, with a calculated volume of 89.7 cc. Whole pelvic irradiation of 50 Gy in 25 fractions was administered, combined with weekly cisplatin injections. KORTUC II injections were given two times: at day 21 (42 Gy) and at day 24 (48 Gy). After finishing whole pelvic irradiation, HDR-ISBT of 25 Gy in 5 fractions b.i.d. over 3 days was administered. KORTUC II was also injected at the time of implantation. Dose-volume histogram (DVH) values for clinical target volume were D(90), D(98), and D(100) of 6.0, 5.0, and 3.5 Gy per fraction, respectively. D(2cc) values were 2.1, 4.1, 3.2, and 2.0 Gy per fraction for the bladder, rectum, sigmoid colon, and small bowel, respectively. No acute adverse events ≥ grade 3 were observed. Repeated grade 3 pyelonephritis occurred as a late complication at 11, 24, and 26 months after the treatment, and was successfully resolved with antibiotics. Moreover, grade 2 late toxicity was documented, including sciatic neuralgia, lower limb lymphedema, and urinary incontinence. At present, 32 months after HDR-ISBT, the patient remains free of disease, with no toxicity-related deterioration in physical condition. Termedia Publishing House 2020-12-16 2020-12 /pmc/articles/PMC7787211/ /pubmed/33437310 http://dx.doi.org/10.5114/jcb.2020.101695 Text en Copyright © 2020 Termedia http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/)
spellingShingle Case Report
Nakata, Mio
Yoshida, Ken
Shimbo, Taiju
Yoshikawa, Nobuhiko
Yoshioka, Hiroto
Hori, Akihiro
Sato, Chikara
Uesugi, Yasuo
Kogata, Yuhei
Masui, Koji
Murakami, Naoya
Kashihara, Tairo
Akiyama, Hironori
Tselis, Nikolaos
Ohmichi, Masahide
Nihei, Keiji
High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report
title High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report
title_full High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report
title_fullStr High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report
title_full_unstemmed High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report
title_short High-dose-rate interstitial brachytherapy with hypoxic radiosensitizer KORTUC II for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report
title_sort high-dose-rate interstitial brachytherapy with hypoxic radiosensitizer kortuc ii for unresectable pelvic sidewall recurrence of uterine cervical cancer: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787211/
https://www.ncbi.nlm.nih.gov/pubmed/33437310
http://dx.doi.org/10.5114/jcb.2020.101695
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