Brachytherapy for isolated vaginal recurrences from endometrial carcinoma

Aims and background: Isolated vaginal recurrences of endometrial carcinoma are rare, and prognostic factors that predict treatment outcome are still n ot well defined. The aim of the present study was to evaluate the results o f brachytherapy in isolated vaginal recurrences from endometrial carcinoma. Methods: Thirty-five patients with isolated vaginal recurrences were treat ed with brachytherapy with intravaginal ovoids or cylinders that were calcu lated to deliver 6000 to 7000 cGy at the surface. Patients were assessed fo r size and location of recurrence at presentation, response and complicatio ns from therapy. Results: Treatment was well tolerated by most patients. Gr ade 2 toxicity occurred in 4 patients (3 cases of partial vaginal stenosis and one proctitis). Complete response to radiation was observed in all pati ents, and an overall 9 failures were observed (4 local, 4 distant and 1 loc al plus distant). Twenty patients (57%) were alive without evidence of dise ase at 3 to 11 years following treatment. Site of vaginal recurrence (upper third versus others) and long (more than 12 months versus less than 12 mon ths) interval from hysterectomy were the only factors significantly related to local failures. Conclusions: Isolated vaginal recurrences following hys terectomy for endometrial carcinoma can be treated with brachytherapy with a low rate of severe toxicity.