Objective: Brachytherapy is an essential component in the definitive treatment of locally advanced cervical cancer to improve local control (LC) and overall survival (OS). This technique requires the placement of the intrauterine tandem through the cervical orifice, which can lead to perforation uterine. The objective of this study is to show the role and benefits of intraoperative ultrasound guidance in cervical brachytherapy.
Materials and methods: A prospective study conducted on 67 patients with locally advanced cervical cancer treated with concurrent chemoradiation followed by intracavitary brachytherapy using ultrasound for real-time assessment of tandem placement in 152 insertions.
Results: The median age of the patients was 52.6 years (33-77). Among the 152 insertions, 3 perforations were detected with a rate of 1.9%. One was on the anterior wall of the uterus, one on the lateral wall, and the last one on the uterine fundus.
Conclusion: intraoperative ultrasound guiding the application is an easy method to provide sure and efficient data to reduce the risk of uterine perforations and the wrong position of the tandem.