Abstract
PURPOSE
For medically inoperable endometrial cancer (MIEC), the volumetric target of image-guided
brachytherapy (IGBT) techniques is not well established. We propose a high-risk CTV
(HRCTV) concept and report associated rates of local control and toxicity.
METHODS AND MATERIALS
For all MIEC patients receiving definitive external beam radiotherapy (EBRT) followed
by MRI-based IGBT at a single institution, BT dose was prescribed to HRCTV defined
as GTV plus endometrial cavity with a planning goal of a summed EQD2 D90 of ≥85 Gy.
Freedom from local progression (FFLP) and overall survival (OS) were estimated via
Kaplan Meier method.
RESULTS
Thirty two MIEC patients received EBRT followed by MRI-based IGBT between December
2015 and August 2020. Median follow up was 19.8 months. A total of 75% of patients
had FIGO stage I/II disease, 56% endometrioid histology, and 50% grade 3 disease.
OS was 73.6% (95% CI 57.8%–89.3%) at 12 months and 65.8% (95% CI 48.4%–83.2%) at 24
months. FFLP was 93.8% (95% CI 85.3%–100%) at 12 months and 88.8% (95% CI 86.6%–91.0%)
at 24 months. 23 (72%) patients experienced no RT-related toxicity, while 2 of 32
patients (6%) experienced late grade 3+ toxicities (grade 3 refractory vomiting; grade
5 GI bleed secondary to RT-induced proctitis).
CONCLUSIONS
Patients with MIEC receiving definitive EBRT followed by MRI-based IGBT prescribed
to the MRI-defined HRCTV demonstrated favorable long-term local control with an acceptable
toxicity profile.
Keywords
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Article info
Publication history
Published online: November 03, 2022
Accepted:
October 7,
2022
Received in revised form:
September 22,
2022
Received:
June 6,
2022
Publication stage
In Press Corrected ProofFootnotes
Disclosures: The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.
Identification
Copyright
© 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
