Abstract
Objective
To investigate the outcomes of definitive external-beam radiation therapy (EBRT) plus
image-guided brachytherapy (IGBT) in patients with endometrial cancer (EC) unsuitable
for surgery.
Methods
A total of 50 patients with inoperable EC were included. The patients received EBRT
in a median dose of 45 Gy to the pelvis over 5 weeks. Thereafter, the patients received
brachytherapy using tandem and ovoid applicators. High-risk clinical target volume
(HR-CTV) and gross tumor volume in brachytherapy (GTVp) were defined by the assistance
of patients’ pre-IGBT magnetic resonance imaging.
Results
The medical records of the 50 patients were analyzed. The main causes of inoperability
were anesthesia contraindications, namely medical comorbidities and obesity. The median
cumulative D90s (the minimum dose delivered to 90% of the volume) in EQD2 (equivalent
dose in 2-Gy fractions) to the HR-CTV and GTVp were 72.9 Gy10 (range, 64.9 to 80.3)
and 166.2 Gy10 (range, 123.0 to 189.8), respectively. Over a median follow-up period
of 27 months, 8 of the patients died of cancer. The 2-year overall and cancer-specific
survival rates were 75% and 83%, respectively. The cumulative incidences of pelvic
and distant failure were 4% (n = 2) and 16% (n = 8), respectively. Gastrointestinal complications of grade 2 or above were noted
in 2 patients (4%), and a grade 2 genitourinary complication was noted in one.
Conclusions
For patients with inoperable EC, EBRT followed by IGBT is an effective approach for
achieving high local control without a high risk of complications.
Keywords
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Article info
Publication history
Published online: October 13, 2022
Accepted:
September 7,
2022
Received in revised form:
September 5,
2022
Received:
May 27,
2022
Identification
Copyright
© 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
