{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:53:08Z","timestamp":1789260788158,"version":"build-2803163510"},"reference-count":48,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>(1) Background: To report the long-term clinical outcomes of computer-tomography (CT)-guided brachytherapy (BT) for locally advanced cervical cancer. (2) Methods: A total of 135 patients with FIGO stage IB-IVA cervical cancer treated with definitive radiotherapy +\/\u2212 chemotherapy with an IGABT boost at Queen Mary Hospital, Hong Kong, between November 2013 and December 2019 were included. Treatment included pelvic radiotherapy 40 Gy\/20 Fr\/4 weeks +\/\u2212 chemotherapy then CT-guided BT (7 Gy \u00d7 4 Fr) and a sequential parametrial boost. The primary outcome was local control. Secondary outcomes were pelvic control, distant metastasis-free survival, overall survival (OS) and late toxicities. (3) Results: The median follow-up was 53.6 months (3.0\u201399.6 months). The five-year local control, pelvic control, distant metastasis-free survival and OS rates were 90.7%, 84.3%, 80.0% and 87.2%, respectively. The incidence of G3\/4 long-term toxicities was 6.7%, including proctitis (2.2%), radiation cystitis (1.5%), bowel perforation (0.7%), ureteric stricture (0.7%) and vaginal stenosis and fistula (0.7%). Patients with adenocarcinomas had worse local control (HR 5.82, 95% CI 1.84\u201318.34, p = 0.003), pelvic control (HR 4.41, 95% CI 1.83\u201310.60, p = 0.001), distant metastasis-free survival (HR 2.83, 95% CI 1.17\u20136.84, p = 0.021) and OS (HR 4.38, 95% CI: 1.52\u201312.67, p = 0.003) rates. Distant metastasis-free survival was associated with HR-CTV volume \u2265 30 cm3 (HR 3.44, 95% CI 1.18\u20139.42, p = 0.025) and the presence of pelvic lymph node (HR 3.44, 95% CI 1.18\u20139.42, p = 0.025). OS was better in patients with concurrent chemotherapy (HR 4.33, 95% CI: 1.40\u201313.33, p = 0.011). (4) Conclusions: CT-guided BT for cervical cancer achieved excellent long-term local control and OS. Adenocarcinoma was associated with worse clinical outcomes. (4) Conclusion: CT-guided BT for cervical cancer achieved excellent long-term local control and OS. Adenocarcinoma was associated with worse clinical outcomes.<\/jats:p>","DOI":"10.3390\/cancers14163934","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T20:58:08Z","timestamp":1660597088000},"page":"3934","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Treatment Outcomes of Computer Tomography-Guided Brachytherapy in Cervical Cancer in Hong Kong: A Retrospective Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9793-9273","authenticated-orcid":false,"given":"Wing-Lok","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3058-4265","authenticated-orcid":false,"given":"Matthew Ho-Fai","family":"Cheng","sequence":"additional","affiliation":[{"name":"LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacky Tsun-Kit","family":"Wu","sequence":"additional","affiliation":[{"name":"LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheuk-Wai","family":"Choi","sequence":"additional","affiliation":[{"name":"School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Piu-Ying","family":"Tse","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patty Piu-Ying","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emina Edith","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8330-0970","authenticated-orcid":false,"given":"Ka-Yu","family":"Test","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-7469","authenticated-orcid":false,"given":"Karen Kar-Loen","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hexane Yuen-Sheung","family":"Ngan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven Wai-Kwan","family":"Siu","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger Kai-Cheong","family":"Ngan","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"},{"name":"Department of Clinical Oncology, Gleneagles Hospital, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Wing-Mui","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China"},{"name":"Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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