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January 16, 2026Cancers0 citationsOpen Access

Salvage Interstitial Brachytherapy for Isolated Local Recurrence of Cervical and Endometrial Cancer: A Retrospective Analysis Stratified by Type of Pelvic Irradiation History

DFDen FujiokaUniversity of Tsukuba TSTakashi SaitoUniversity of Tsukuba TSTaisuke SumiyaUniversity of Tsukuba

Key Points

This research aims to assess the effectiveness and safety of salvage interstitial brachytherapy (S-ISBT) for isolated local recurrence of cervical and endometrial cancers based on patients' irradiation history.
Retrospective review of patients with isolated local recurrence treated with S-ISBT.
Grouping by treatment history: surgery, surgery with radiotherapy, and definitive radiotherapy.
Estimation of overall survival, progression-free survival, local control rates, and late adverse events.
Multivariate analysis to identify prognostic factors.
3-year overall survival rates were 80.8% for Group A, 66.7% for Group B, and 30.4% for Group C (p < 0.001).
Progression-free survival rates were 56.4% for Group A, 41.5% for Group B, and 11.6% for Group C (p < 0.001).
Local control rates were 89.1% for Group A, 61.4% for Group B, and 43.0% for Group C (p = 0.002).
No significant differences were found between Groups A and B, while Group C showed a higher risk relative to Group B.

Abstract

Background/Objectives: This study evaluated the efficacy and safety of salvage interstitial brachytherapy (S-ISBT) for isolated local recurrence (ILR) of cervical and endometrial carcinoma, stratifying patients by pelvic irradiation history (PIH). Methods: Patients with ILR treated with S-ISBT were retrospectively reviewed and categorized by initial treatment: Group A (surgery alone); Group B (surgery + postoperative radiotherapy (RT)); and Group C (definitive RT). Overall survival (OS), progression-free survival (PFS), local control (LC) rates, and the cumulative incidence functions (CIFs) for Grade ≥ 3 late adverse events (AEs) were estimated. Multivariate analysis identified prognostic factors. Results: The study included 70 patients (A: 28, B: 17, C: 25) with a median follow-up of 33.4 months. The 3-year OS, PFS, LC, and CIFs for Grade ≥ 3 late AEs for Groups A, B, and C were 80.8%, 66.7%, and 30.4% (p < 0.001); 56.4%, 41.5%, and 11.6% (p < 0.001); 89.1%, 61.4%, and 43.0% (p = 0.002); and 26.4%, 13.3%, and 32.0% (p = 0.40), respectively. Multivariate analysis suggested the type of PIH, disease-free interval, and tumor volume as independent prognostic factors. While no significant differences were observed between Groups A and B (OS: HR = 0.47, p = 0.19; PFS: HR = 0.60, p = 0.28), Group C exhibited a significantly higher risk than Group B (OS: HR = 3.08, p = 0.018; PFS: HR = 3.41, p = 0.004). Conclusions: S-ISBT could be considered for patients with prior postoperative RT, whose outcomes are significantly better than those with prior definitive RT.

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