High-dose-rate brachytherapy alone post-hysterectomy for endometrial cancer

Purpose: To evaluate the outcome of post-hysterectomy adjuvant vaginal high -dose-rate (HDR) brachytherapy. Methods and Materials: A retrospective analysis was performed on a series o f 143 patients with endometrial cancer treated with HDR brachytherapy alone post-hysterectomy from 1985 to June 1993, Of these patients, 141 received 34 Gy in four fractions prescribed to the vaginal mucosa in a 2-week period . The median follow-up was 6.9 years. Patients were analyzed for treatment parameters, survival, local recurrence, distant relapse, and toxicity. Results: Five-year relapse free survival and overall survival was 100% and 88% for Stage 1A, 98% and 94% for Stage IB, 100% and 86% for Stage IC, and 92% and 92% for Stage IIA. The overall vaginal recurrence rate was 1.4%. Th e overall late-toxicity rate was low, and no RTOG grade 3, 4, or 5 complica tions were recorded. Conclusion: These results are similar to reported international series that have used either low-dose-rate or HDR brachytherapy. The biological effect ive dose was low for both acute and late responding tissues compared with s ome of the HDR brachytherapy series, and supports using this lower dose and possibly decreasing late side-effects with no apparent increased risk of v aginal recurrence. (C) 1998 Elsevier Science Inc.