Targeted Radiation Treatment for Cervical Cancer Available Close to Home

In 2020, the American Society for Radiation Oncology, issued its first clinical guidelines to treat individuals with nonmetastatic cervical cancer. The guidelines note that cervical cancer treatment has dramatically advanced over the past 20 years, with intensity-modulated radiation therapy (IMRT) and image-guided brachytherapy, in particular, resulting in better patient outcomes with fewer complications.

The guidelines strongly recommend brachytherapy for people receiving definitive radiation or chemoradiation and note that neither stereotactic body radiation therapy (SBRT) nor IMRT alone is a suitable substitute for brachytherapy.

At Lehigh Valley Hospital (LVH)–Cedar Crest and LVH–Pocono, individuals can now receive a highly targeted form of interstitial brachytherapy delivered through a template with openings that guide the needles delivering radiation into place.

The treatment, Syed-Neblett template brachytherapy, is appropriate for people with newly diagnosed or recurrent cervical cancer who have had a hysterectomy, or for those with locally advanced cervical cancer with intact uteruses who may benefit from a high dose of targeted radiation.

“The goal is to deliver radiation to the cervix and the adjacent tissue, as well as the upper portion of the vagina, and spare surrounding structures,” says Christine Kim, MD, with LVPG Gynecology, Lehigh Valley Topper Cancer Institute.

To prepare patients for radiation treatment, Dr. Kim sutures the Syed-Neblett template to the vulva and then uses intra-abdominal laparoscopic guidance to place the brachytherapy needles. After it is in place, patients are admitted and placed on bed rest.

Radiation treatments are then given twice a day for three days, with the template serving as a guide for the brachytherapy needles.

“We’re able to deliver radiation from within the tumor with an incredibly high degree of precision and accuracy,” says radiation oncologist Sean Quinlan-Davidson, MD, with Allentown Radiation Oncology Associates at LVH–Pocono, Lehigh Valley Topper Cancer Institute.

“We’ve achieved great outcomes with this technique technique,” Dr. Quinlan-Davidson adds. He notes that although people do need to be admitted and the procedure itself is invasive, it is well tolerated, with few bleeding or pain issues. “We had one 78-year-old patient who went to bingo the evening after she was discharged,” he says.

Cervical cancer affects about 13,800 American women annually. The estimated five-year survival rate is 92 percent for early-stage disease; however, the survival rate drops to 56 percent for women with locally advanced disease. Dr. Kim notes that this may be due to undertreatment, since targeted brachytherapy techniques are not widely available.

“We want patients and referring physicians to know that we now have the ability and the technology to effectively treat advanced cases of cervical cancer in patients with complex anatomy,” Dr. Kim says.