KORTUC, a novel hydrogen peroxide‑based radiosensitizer for the enhancement of brachytherapy in patients with unresectable recurrent uterine cervical cancer

Shimbo,Taiju; Yoshida,Ken; Nakata,Mio; Kobata,Kazuma; Ogawa,Takashi; Kihara,Ayaka; Sato,Chikara; Hori,Akihiro; Takeno,Satoshi; Yoshioka,Hiroto; Akiyama,Hironori; Nihei,Keiji

doi:10.3892/ol.2023.13964

KORTUC, a novel hydrogen peroxide‑based radiosensitizer for the enhancement of brachytherapy in patients with unresectable recurrent uterine cervical cancer

Authors:
- Taiju Shimbo
- Ken Yoshida
- Mio Nakata
- Kazuma Kobata
- Takashi Ogawa
- Ayaka Kihara
- Chikara Sato
- Akihiro Hori
- Satoshi Takeno
- Hiroto Yoshioka
- Hironori Akiyama
- Keiji Nihei
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Affiliations: Department of Radiation Oncology, Osaka Medical and Pharmaceutical University, Takatuki, Osaka 569‑8686, Japan, Department of Radiology, Kansai Medical University Medical Center, Moriguti, Osaka 573‑1121, Japan, Department of Dental Radiology, Osaka Dental University, Hirakata, Osaka 570‑8507, Japan
Published online on: July 20, 2023 https://doi.org/10.3892/ol.2023.13964
Article Number: 378
Copyright: © Shimbo et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Kochi Oxydol Radiation Therapy for Unresectable Carcinoma (KORTUC) is a novel radiosensitizer invented by Professor Ogawa at Kochi University (Japan) in 2006. The current study aimed to report the experience of the present authors with the use of KORTUC treatment in combination with interstitial brachytherapy (ISBT), with or without external beam (EB) radiotherapy (RT), in patients with locally recurrent cervical cancer (LRCC), who were likely to have a high risk of poor prognosis. Between April 2012 and January 2020, 14 female patients (15 tumoral lesions) with LRCC underwent KORTUC with ISBT. Their previous treatments included surgery (n=4), radiation therapy (n=8) and surgery plus RT (n=3). The primary lesions were located in the vaginal stump (n=5), pelvic wall (n=3), cervix (n=3), vaginal wall (n=2) and lymph nodes (n=2). At 2 h before RT, KORTUC was injected intratumorally via direct colposcopy. The dose of KORTUC ranged from 4‑12 ml, adjusted for the tumor size. For patients who underwent ISBT, KORTUC was administered before and after insertion of the applicator before irradiation. Intratumoral injection of KORTUC was completed without any technical or safety issues in all 15 patients; it was well tolerated with no adverse events observed. KORTUC also showed preferable efficacy; a clinical complete response was observed in 87% of patients and the initial response rate was 100%. The 2‑year local control rate in patients who underwent ISBT + KORTUC was 79%, whereas it was 63% in the re‑irradiation group which was significantly lower (P=0.02) than that in the non‑irradiation group (100%). Based on this finding, KORTUC with external irradiation is considered to be an optimal treatment strategy for patients with newly diagnosed LRCC this disease. Additionally, KORTUC may be an effective radiation response enhancer in multiple cancer types in which locoregional control after RT alone remains poor.

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