Abstract:

Background: High-Dose-Rate Intracavitary Brachytherapy (HDR-ICBT) is a commonly employed treatment modality for cervical cancer, delivering a high dose of radiation directly to the tumor site while minimizing exposure to surrounding healthy tissues. Anesthesia administration during HDR-ICBT varies, with some centers using Sedation (CS) and others employing General Anesthesia (GA). Despite the widespread use of these anesthesia techniques, their potential impact on dosimetric outcomes, particularly in the urinary bladder and rectum, remains an area of interest and investigation.

Objective: This study aimed to determine the dosimetric difference in the urinary bladder and rectum doses among cervical cancer patients undergoing HDR-ICBT under CS and GA. The research was conducted at Bugando Cancer Center (BCC) and Ocean Road Cancer Institute (ORCI) to compare the dosimetric outcomes between the two anesthesia techniques.

Methods: A total of 273 patients who underwent HDR-ICBT for cervical cancer were included in the study. Patients were divided into two groups based on the anesthesia technique used during the procedure: 143 patients received GA, and 130 patients received CS. Dosimetric parameters of the urinary bladder and rectum doses were collected and analyzed using descriptive statistics and the independent samples t-test.

Results: The findings demonstrated a statistically significant dosimetric difference in the mean urinary bladder dose between patients treated under GA and CS (p < 0.001). Patients under GA received a significantly lower mean urinary bladder dose compared to those under CS. However, no statistically significant difference was observed in the mean rectum dose between the two anesthesia groups (p = 0.689).

Conclusion: Our study reveals that the choice of anesthesia technique significantly impacts the urinary bladder dose during HDR-ICBT for cervical cancer. Patients receiving GA had a lower mean urinary bladder dose compared to those under CS. However, no significant dosimetric difference was observed in the mean rectum dose between the two anesthesia groups. These findings emphasize the importance of considering anesthesia techniques during treatment planning to optimize dosimetric outcomes and patient safety in HDR-ICBT. Further investigation and long-term follow-up are warranted to validate and expand upon these results. Collaboration between radiation oncologists and anesthesia teams is crucial to enhance treatment efficacy and minimize potential complications during HDR-ICBT for cervical cancer.