Image-based three-dimensional conformal brachytherapy for medically inoperable endometrial carcinoma

Consensus statement for brachytherapy for the treatment of medically inoperable endometrial cancer

“…Given the excellent local control rates observed in this study, these results suggest that high doses to the CTV are not necessary to control disease, particularly in Stage I patients, provided that the GTV receives adequate dose. Longer followup and supporting data from a multiinstitutional setting are needed to validate these results (32).…”

“…Gill et al (32) recently published initial clinical outcome data for 38 medically inoperable endometrial cancer patients treated with image-guided brachytherapy. Nineteen patients underwent MRI-based planning where an MRI was performed after applicator placement; 19 underwent CT-based planning with 13 of these having a diagnostic MRI before brachytherapy to assist in identifying the GTV; 20 patients were treated with brachytherapy alone to a median dose of 37.5 Gy in five or six fractions; 18 were treated with a combination of external beam radiation to 45 Gy followed by an additional 25 Gy in four to five fractions with brachytherapy.…”

Image Guided High Dose Rate Intracavitary Brachytherapy in the Treatment of Medically Inoperable Early Stage Endometrioid Type Endometrial Adenocarcinoma

“…[3][4][5][6] The dosimetry techniques used in this cohort demonstrate that lower radiotherapy doses to the CTV may provide similar efficacy to the ABS recommended minimum doses. The use of a single tandem in combination with EBRT allows greater flexibility in dose distribution without requiring the use of multiple applicators or dose delivery under general anesthesia.…”

Current Concepts in Radiation Therapy for Early-Stage Endometrial Cancer

“…In the largest series to date with 280 patients treated using conventional intracavitary brachytherapy, 5-year local control rates for clinical stage IA and stage IB patients were 86.0 and 68.8 % [60]. In the modern era with incorporation of IGBT, local control rates range from 90.6 to 100.0 % with no severe toxicities reported [64,66]. In view of these studies, the American Brachytherapy Society (ABS) recently published guidelines defining radiotherapy, integrating brachytherapy, as an acceptable alternative to surgery in patients with significant medical comorbidities [67].…”

“…For a small subset (3.5-9.0 %) of patients, surgery is not feasible due to the presence of medical comorbidities and advanced age [58,59]. Radiotherapy alone, frequently incorporating brachytherapy, has been shown to yield favorable outcomes in early-stage disease [60][61][62][63][64][65][66]. In the largest series to date with 280 patients treated using conventional intracavitary brachytherapy, 5-year local control rates for clinical stage IA and stage IB patients were 86.0 and 68.8 % [60].…”