High Dose Rate Brachytherapy for Inoperable Endometrial Cancer: a Case Series and Systematic Review of the Literature

S. Mutyala, G. Patel, A. C. Rivera, P. N. Brodin, K. Saigal, N. Thawani, K. J. Mehta

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Endometrial cancer is a common gynaecological cancer, is typically early stage and treated with surgery. For patients where surgery is difficult or dangerous, definitive radiation therapy is the next best option. This study included a single institution case series (step 1) and a systematic review of the literature (step 2). In step 1, all endometrial cancer cases that were treated with definitive image-guided brachytherapy at a single institution from 2008 to 2020 were retrospectively analysed. In step 2, a systematic review of Medline (PubMed) from 1975 to 2020 was carried out using the key words around endometrial cancer and brachytherapy, followed by a narrative synthesis. In total, in step 1, 31 cases were included in this study, stages I–IV, with 96.7% receiving external beam radiation. All patients received three fractions of 7.5 Gy or five fractions of 6 Gy high dose rate brachytherapy, with a median EQD2 of 75.55 (40–84.3). The 2-year Kaplan-Meier (KM) local control was 83.1% and the 2-year KM overall survival was 77.4%. There was no late toxicity ≥grade 3. In step 2, 19 articles were included in the final analysis, with between six and 280 patients. The local control ranged from 70 to 100%, with low toxicity. Definitive radiation therapy with image-guided brachytherapy seems to have good local control with low toxicity for patients who are poor surgical candidates.

Original languageEnglish (US)
Pages (from-to)e393-e402
JournalClinical Oncology
Volume33
Issue number9
DOIs
StatePublished - Sep 2021

Keywords

  • Brachytherapy
  • endometrial carcinoma
  • image-guided brachytherapy
  • radiation therapy
  • systematic review
  • uterine cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

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