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Peer-reviewedCC BYCureus

Freehand Needle Hybrid Brachytherapy in Complex Gynecological Cancers.

  • Sadia Sadiq1
  • Rafia Usman2
  • Asia Razzaq3
  • Rab Nawaz Maken2
  1. 1Radiation Oncology, Institute of Nuclear Medicine and Oncology (INMOL) Atomic Energy Cancer Hospital, Lahore, PAK.
  2. 2Oncology, Institute of Nuclear Medicine and Oncology (INMOL) Atomic Energy Cancer Hospital, Lahore, PAK.
  3. 3Medical Physics, Institute of Nuclear Medicine and Oncology (INMOL) Atomic Energy Cancer Hospital, Lahore, PAK.
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Abstract

Hybrid intracavitary-interstitial brachytherapy improves local control in complex gynecologic malignancies. However, access to advanced applicators remains limited in resource-constrained settings. We present a case series of three patients with challenging anatomical and disease characteristics in whom personalized hybrid brachytherapy was performed using freehand interstitial needle placement. All patients received standard chemoradiation followed by CT-guided brachytherapy. Due to inadequate coverage with conventional applicators, individualized freehand needle placement was performed and stabilized using locally available materials. Adequate dosimetric coverage of the high-risk clinical target volume was achieved in all cases while respecting organ-at-risk constraints. Two patients demonstrated a complete response on follow-up imaging, while one showed excellent clinical response. This report highlights a practical, cost-effective alternative when advanced templates are unavailable and underscores the importance of innovation in resource-limited environments.

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Cite

BibTeXRIS
BibTeX
@article{sadiq2026freehand,
  title = {{Freehand Needle Hybrid Brachytherapy in Complex Gynecological Cancers.}},
  author = {Sadia Sadiq and Rafia Usman and Asia Razzaq and Rab Nawaz Maken},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116998},
  url = {https://europepmc.org/article/MED/42948650},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Freehand Needle Hybrid Brachytherapy in Complex Gynecological Cancers.
AU  - Sadia Sadiq
AU  - Rafia Usman
AU  - Asia Razzaq
AU  - Rab Nawaz Maken
PY  - 2026
DA  - 2026/09/27
JO  - Cureus
DO  - 10.7759/cureus.116998
UR  - https://europepmc.org/article/MED/42948650
AB  - Hybrid intracavitary-interstitial brachytherapy improves local control in complex gynecologic malignancies. However, access to advanced applicators remains limited in resource-constrained settings. We present a case series of three patients with challenging anatomical and disease characteristics in whom personalized hybrid brachytherapy was performed using freehand interstitial needle placement. All patients received standard chemoradiation followed by CT-guided brachytherapy. Due to inadequate coverage with conventional applicators, individualized freehand needle placement was performed and stabilized using locally available materials. Adequate dosimetric coverage of the high-risk clinical target volume was achieved in all cases while respecting organ-at-risk constraints. Two patients demonstrated a complete response on follow-up imaging, while one showed excellent clinical response. This report highlights a practical, cost-effective alternative when advanced templates are unavailable and underscores the importance of innovation in resource-limited environments.
SN  - 2168-8184
ER  -