Comparison of high-dose-rate and low-dose-rate brachytherapy in the treatment of endometrial carcinoma

Fayed, Alaa; Mutch, David G.; Rader, Janet S.; Gibb, Randall K.; Powell, Matthew A.; Wright, Jason D.; El-Naqa, I.; Zoberi, Imran; Grigsby, Perry W.

doi:10.1016/j.ijrobp.2006.09.004

Cited by 36 publications

(23 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies of VBT demonstrate low rates of high-grade vaginal complications, which can be significantly reduced with the use of lower dose per fraction regimens. Severe toxicity rates are 0–5.2%, which are primarily vaginal in nature, as shown in Table 5 [2,6,15–24,26–29,31,32,36–38,63]. …”

Section: Toxicitymentioning

confidence: 99%

See 1 more Smart Citation

American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review

et al. 2017

View full text Add to dashboard Cite

This article aims to review the risk stratification of endometrial cancer, treatment rationale, outcomes, treatment planning, and treatment recommendations of vaginal brachytherapy (VBT) in the post-operative management of endometrial cancer patients. The authors performed a thorough review of the literature and reference pertinent articles pertaining to the aims of this review. Adjuvant VBT for early stage endometrial cancer patients results in very low rates of vaginal recurrence (0–3.1%) with low rates of late toxicity which are primarily vaginal in nature. PORTEC-2 supports that VBT results in non-inferior rates of vaginal recurrence compared to external beam radiotherapy (EBRT) for the treatment of high-intermediate risk patients. VBT as a boost following EBRT, in combination with chemotherapy, and for high-risk histologies have shown excellent results as well though randomized data do not exist supporting VBT boost. There are many different applicators, dose-fractionation schedules, and treatment planning techniques which all result in favorable clinical outcomes and low rates of toxicity. Recommendations have been published by the American Brachytherapy Society and the American Society of Radiation Oncology to help guide practitioners in the use of VBT. Data support that patients and physicians both prefer joint decision-making regarding the use of VBT, and patients often desire additional treatment for a marginal benefit in risk of recurrence. Discussions regarding adjuvant therapy for endometrial cancer are best performed in a multi-disciplinary setting and patients should be counseled properly regarding the risks and benefits of adjuvant therapy.

show abstract

Section: Toxicitymentioning

confidence: 99%

“…Fayed et al compared HDR (2 Gy for 6 fractions to 0.5cm depth) to LDR (60–70 Gy to the vaginal surface) VBT and showed no difference in grade 3–4 toxicity [63]. HDR VBT is being used by 96% of brachytherapists, which is a significant increase over the past decade.…”

Section: Toxicitymentioning

confidence: 99%

American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Brachytherapy is also used for patients with recurrent endometrial carcinoma, and in this setting is sometimes interstitial rather than intracavitary. Definitive irradiation requiring brachytherapy is used infrequently for patients with medically inoperable endometrial carcinoma (15)(16)(17)(18).…”

Section: Endometrial Cancermentioning

confidence: 99%

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

Erickson

Demanes

Hayes³

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

“…In approximately 10% of patients, endometrial carcinoma involves the cervix [3–6]. However, there is a relative lack of consensus regarding the most appropriate management strategy for these patients.…”

Section: Purposementioning

confidence: 99%

Clinical Investigations Preoperative high dose rate brachytherapy for clinical stage II endometrial carcinoma

Shukla

Beriwal

Krivak

et al. 2011

jcb

View full text Add to dashboard Cite

PurposeWe sought to evaluate pathological response, tolerance, and outcome after preoperative (neoadjuvant) high dose rate brachytherapy in a small series of patients with clinical stage II endometrial carcinoma, and to evaluate a dose and fractionation protocol for this treatment.Material and methodsTwelve women diagnosed with clinical stage II endometrial carcinoma from 1999-2010 were treated with preoperative radiation therapy. Their medical charts were retrospectively analyzed for HDR treatment regimen, pathological response, and longitudinal outcomes. Radiation doses were normalized to a biologically equivalent dose of 2 Gy per fraction (EQD2).ResultsTwo patients had complete pathological response to neoadjuvant therapy; five more had only microscopic residual disease at the time of surgery. At a median follow up of 37 months (1-91 months), one patient has developed recurrence at the vaginal apex six months after completing initial therapy, while another developed a lung recurrence at 28 months. Two-year disease-free and cause-specific survivals were 88% and 100%, respectively.ConclusionsOur small study shows that the HDR fractionation schedule, as done in our series for preoperative radiation therapy for clinical stage II endometrial cancer, is well tolerated and would be an option for patients treated with neoadjuvant radiation therapy.

show abstract

Comparison of high-dose-rate and low-dose-rate brachytherapy in the treatment of endometrial carcinoma

Cited by 36 publications

References 7 publications

American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review

American Brachytherapy Task Group Report: Adjuvant vaginal brachytherapy for early-stage endometrial cancer: A comprehensive review

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

Clinical Investigations Preoperative high dose rate brachytherapy for clinical stage II endometrial carcinoma

Contact Info

Product

Resources

About