Clinical and Dosimetric Comparison of Interstitial Applications Using Martinez Universal Perineal Interstitial Template (MUPIT) and Syed–Neblett Template for Carcinoma Cervix
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MUPIT and Syed–Neblett Template are the two commonly used systems for interstitial brachytherapy for gynecological cancers in India. A retrospective study was done to compare and evaluate the outcome, dosimetric data and the toxicities of the two perineal template-based high dose rate brachytherapies in patients diagnosed of cervical cancer and vaginal carcinoma.
Materials and Methods
Between January 2010 and January 2013, 62 patients treated with interstitial transperineal brachytherapy using MUPIT and Syed–Neblett Template at a tertiary care center of Eastern India were included in the study. The median EBRT dose was 50 Gy; ISRT (interstitial brachytherapy) dose was 21 Gy. The dosimetric data and clinical outcome and the toxicity profile were obtained from our file archive and TPS archives. These were correlated with follow-up status regarding toxicity and locoregional recurrence and control.
During the study period, 62 patients received ISRT of which 8 were of vault recurrence. Of these 62 patients, 37 were treated using Syed–Neblett and 25 using MUPIT. Median age was 45 years; ISRT dose was similar in both groups (21 Gy in 3 fractions once a week). The mean EQD2 to the 2 cc bladder and 2 cc rectum was 75.4 Gy and 72.21 Gy in the Syed cohort and 76.83 Gy and 75.38 Gy in the MUPIT cohort, respectively (p = 0.12 and 0.09). Acute toxicity was mostly grade 1 and 2 genitourinary (%) or grade 1 and 2 rectal (%). Most common late toxicity was gastrointestinal bleeding and dysuria: 16.22% and 8.35% in the Neblett arm and 18.18 and 9% in the MUPIT arm. With a median follow-up of 27 months, the local control rate was 53% in the Neblett arm and 67% in the MUPIT arm (p = .32).
Though there were differences between the dose volumes received by the OAR and the target, the local control rates and long-term normal tissue toxicity were found to be not significantly different between the two systems of transperineal brachytherapy for cervical cancers.
KeywordsTransperineal interstitial brachytherapy MUPIT Syed Neblett Carcinoma cervix
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
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