S59
Brachytherapy - Gynaecology
ESTRO 2026
Conclusion: The use of individualized applicators resulted in improved target volume coverage without exceeding OARs dose constraints. Further follow-up is required to determine whether these dosimetric advantages translate into improved local control and survival outcomes. Keywords: cervical cancer, brachytherapy, applicators References: 1. Zobec Logar H.B., Hudej R., Š egedin B. Development and assessment of 3D-printed individual
the rectum, sigmoid, and bowel. Results:
A total of 35 patients were included: 31 with locally advanced cervical cancer (FIGO stage IB2–IVA) and 4 with recurrent cervical cancer following primary surgery. The mean age was 56.7 ± 13.9 years, and the mean follow-up was 33.1 ± 25.8 months. Squamous cell carcinoma was present in all but one patient. All patients received external beam radiotherapy with a total dose of 45 Gy in 25 fractions; 18 received a nodal boost up to 57.5 ± 1.6 Gy. Concurrent chemotherapy was administered to 35 patients, of whom 24 received five cycles of cisplatin or carboplatin. Brachytherapy was delivered using either PDR or HDR technique: PDR 2 × 18.5 Gy (25 patients) or HDR 4 × 7 Gy (10 patients). The dosimetric comparison demonstrated consistent improvements in DVH parameters with individualized applicators compared with standard or simulated standard applicators (Figure 1), yielding higher target coverage (HR-CTV D90, D98, V100, D100; reduced underdosed HR-CTV volume; GTV D98, D100) without exceeding OARs dose constraints. Detailed dosimetric results are presented in Figure 2.
applicators in gynecological MRI-guided brachytherapy. Journal of Contemporary
Brachytherapy. 2019;11(2):128-136.2. Segedin B., Kobav M., Zobec Logar H.B. The Use of 3D Printing Technology in Gynaecological Brachytherapy—A Narrative Review. Cancers. 2023;15(16):4165.3. Berger D, Van Dyk S, Beaulieu L, Major T, Kron T. Clinical Oncology (Royal College of Radiologists (Great Britain)). 2023;35(8):e453-e468.4. Cunha JAM, Flynn R, Bélanger C, et al. Seminars in Radiation Oncology. 2020;30(1):94-106. Digital Poster 2003 Multimodality image-guided hybrid brachytherapy for LACC: real-world dosimetry, outcomes and dose–response in 120 patients Yuanjie Cao 1 , Imashi Sandupama Wickramage 2 , Chen Li 1 , Youheng Tan 3,4 , Wenwen Zhang 1 , Wei Wang 1 , Qingsong Pang 1 , Jie Chen 1 1 Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China. 2 Department of Radiation Oncology, Tianjin Medical University, Tianjin, China. 3 School of Automation, Central South University, Changsha, China. 4 CEO, Suzhou Puneng Medical Technology Co.,Ltd, Suzhou, China Purpose/Objective: To evaluate feasibility, dosimetry, clinical outcomes and dose–response of multimodality image-guided brachytherapy (IGBT) for locally advanced cervical cancer (LACC) in real-world practice, including conventional intracavitary–interstitial and flexible hybrid approaches. Material/Methods: Between 2023 and 2025, 120 consecutive LACC patients received external-beam radiotherapy (45–50.4 Gy) plus high-dose-rate IGBT (4–5 fractions) with concurrent cisplatin. A multimodality workflow integrated CT/MRI fusion for target delineation, virtual modelling, and fabrication of patient-specific 3D- printed templates guiding an individualized intracavitary + straight-needle + flexible-needle hybrid system.Plans were optimized per GEC-ESTRO/ICRU-89
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