ArticleFrontiers in oncology2026
Comparison of long-term prognoses between 3D-printed template-guided and conventional freehand interstitial brachytherapy for locally advanced cervical cancer: a single-center retrospective study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Conventional freehand three-dimensional interstitial brachytherapy (F-3DIB) for locally advanced cervical cancer (LACC) is limited by suboptimal dose distribution and operator dependency. This study aimed to evaluate the long-term survival and safety benefits of 3D-printed template-guided interstitial brachytherapy (3D-PTIB). Methods: This retrospective single-center cohort study included 300 patients with FIGO IIB-IVA LACC who underwent brachytherapy between January 2021 and June 2022. The median follow-up time was 36.2 months (range: 34-41). Follow-up data were collected between January 2024 and June 2025, ensuring adequate follow-up for survival assessment. Patients were divided into 3D-PTIB and F-3DIB groups. Propensity score matching was used to balance baseline characteristics, resulting in a matched cohort of 240 patients. The outcomes assessed included 3-year overall survival (OS), progression-free survival (PFS), local control (LC), dosimetric parameters, and late toxicities. Results: The 3D-PTIB group exhibited significantly better 3-year OS (76.7% vs. 66.2%, HR = 0.69, p = 0.02) and LC (90.0% vs. 78.3%, HR = 0.47, p = 0.01) than the F-3DIB group. A trend toward improved 3-year PFS was also observed (70.8% vs. 62.3%, HR = 0.73, p = 0.05). Notably, the 3D-PTIB group achieved an 11.7% absolute improvement in local control (90.0% vs. 78.3%). A Conclusion: 3D-printed template-guided interstitial brachytherapy significantly improves intermediate- to long-term survival and reduces late toxicity in LACC patients, particularly high-risk patients with a tumor diameter > 4 cm or parametrial invasion, highlighting its potential as a superior alternative to conventional freehand interstitial brachytherapy.
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