Journal of Contemporary Brachytherapy
eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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3/2025
vol. 17
 
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abstract:
Case report

Near-fatal saddle pulmonary embolism following chemoradiotherapy and brachytherapy for locally advanced cervical cancer: A case series

Lisa Leijtens
1, 2
,
Jurgen Piek
1
,
Marlijn Kamps
3
,
Ada Oele-Egelmeer
4
,
Alette Daniëls-Gooszen
5
,
Ruud Bekkers
1, 2, 6
,
Jeltsje Cnossen
7

  1. Department of Obstetrics and Gynecology, Catharina Cancer Institute, Catharina Hospital, Eindhoven, the Netherlands
  2. GROW – Research Institute for Oncology and Reproduction, Maastricht University, the Netherlands
  3. Department of Intensive Care, Catharina Hospital, Eindhoven, the Netherlands
  4. Department of Radiation Oncology, Institute Verbeeten, Tilburg, the Netherlands
  5. Department of Radiology, Catharina Hospital, Eindhoven, the Netherlands
  6. Department of Gynecology, Radboudumc, Nijmegen, the Netherlands
  7. Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands
J Contemp Brachytherapy 2025; 17, 3: 197–201
DOI: https://doi.org/10.5114/jcb.2025.152543
Online publish date: 2025/06/30
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Purpose:
Women with locally advanced cervical cancer treated with chemoradiotherapy followed by brachytherapy are at increased risk of venous thromboembolic events.

Case presentation:
This case series reported three women, who experienced near-fatal saddle pulmonary embolisms shortly after undergoing high-dose-rate brachytherapy for locally advanced cervical cancer. In one patient, pulmonary saddle embolism led to hypovolemic shock due to intra-abdominal hemorrhage post-resuscitation, necessitating emergency decompressive laparotomy. Another case was complicated by neurological symptoms consistent with a stuttering stroke, following mechanical pulmonary thrombectomy.

Conclusions:
Pulmonary embolism represents a severe complication of chemoradiotherapy and brachytherapy. Given the high morbidity and mortality rates associated with this condition, routine thromboprophylaxis may be warranted.

keywords:

cervical cancer, saddle pulmonary embolism, brachytherapy, chemoradiotherapy, thromboprophylaxis

  
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