Brachytherapy of Malignant Neoplasms of the Cervix Uteri: Current Status of the Problem (Literature Review)

Abstract

Purpose: To conduct a search and generalization of literature data to assess the relevance and prospects for the development of brachytherapy in the treatment of cervical cancer. Material and methods: Scientific sources were searched in PubMed / Medline for the following key words: «cervical cancer», «radiotherapy», «brachytherapy». The time horizon covered 2016–2023. Using a time filter, the most relevant and innovative research papers on cervical cancer brachytherapy were selected. Results: Modern radiology provides specialists with a wide range of methods, one of which is brachytherapy (BT). Brachytherapy is a promising direction in the treatment of cervical cancer, however, its use is largely limited and continues to gradually progressively decline around the world. The reasons associated with this are different: the complex technical component of this technique, the high requirements for the training of BT specialists, the high cost of treatment, and others. However, it should be noted that most of the current data demonstrate the high efficacy of BT in the complex therapy of cervical cancer. Therefore, research is ongoing to increase the involvement of BT in the treatment strategy for cervical cancer. Thus, many authors emphasize that the rates of primary complete remission and 5-year cancer-specific survival were significantly higher in patients treated with BT than in those who were treated with EBRT instead of BT (92.5 % versus 73.3 % and 68. 5 % versus 35.4 % respectively). Modern technical developments in the field of BT are also interesting, for example, the use of 3D printing methods. New applicators make it possible to increase the conformity of the conducted BT. The presented methodology also provides an opportunity for better training of specialists in the field of BT. An important aspect of the spread of BT and radiological treatment in general, and along with it the dynamics of the main indicators of survival, is still the socioeconomic factor. Thus, there are direct correlations between the total income of a country and the degree of prevalence of BT in it. Some countries are almost completely deprived of the possibility of using BT methods in health care. In general, brachytherapy is actively developing, opening up new horizons in the treatment of malignant neoplasms of cervical cancer.