The preliminary report of a single-channel applicator in the HDR afterloading brachytherapy for cervical cancer.

To evaluate whether the patent single-channel applicator, which was modified from the traditional tandem applicator and wrapped with a oval-shield alloy around the source channel, has the same clinical efficacy and safety as the standard Fletcher-type applicator in the high-dose-rate brachytherapy for carcinoma of the cervix. Between December 2011 and February 2017, 299 patients with pathologically confirmed International Federation of Gynecology and Obstetrics (FIGO 2009) stage Ib2-IVa cervical cancer were received and finished the allocated intervention, with the first 151 patients, 71 in the Fletcher group and 80 in the patent single-channel group, satisfying the criteria for a preliminary analysis. All but three patients were treated with concurrent cisplatin chemotherapy and external beam radiotherapy followed by high-dose-rate brachytherapy. The 2-year OS, PFS and LRFSS was 80.3%, 77.5% and 78.9% for the Fletcher group, and for the single-channel group was 86.3%, 82.5% and 83.8%, respectively. The seriousness of acute treatment-related toxicities was similar in the two groups. The cumulative rate of late rectal complications for Grade 3-4 in the Fletcher group and the single-channel group was 2.8% and 2.5%, respectively. The cumulative rate of Grade 3 bladder complications was 2.8% for the Fletcher group and 1.3% for the single-channel group. The preliminary results of our study shows that the patent single-channel intracavitary applicator may be able to provide a protection for the rectum and bladder, and seems to have the same clinical efficacy as the standard Fletcher type three-channel applicator in the high-dose-rate brachytherapy for carcinoma of the cervix. This trial was registered in the Chinese Clinical Trial Registry, and the registration number was ChiCTR-TRC-12002321. This article is protected by copyright. All rights reserved.