Resumen de Daily schedule for high-dose-rate brachytherapy in postoperative treatment of endometrial carcinoma

Angeles Rovirosa Casino, Izaskun Valduvieco Ruiz, Carlos Ascaso Terrén, Antonio Herreros, C. Bautista, Ingrid Romera, Meritxell Arenas Prat, Jaume Pahisa, Alberto Biete Solà

• Purpose To analyze the results of daily high-dose-rate brachytherapy (HDRBT) on local control and toxicity in the postoperative treatment of endometrial carcinoma (EC).

  Materials and methods From January 2007 to September 2010, 112 patients were treated with HDRBT after surgery for EC. FIGO staging: 24-IA, 48-IB, 14-II, 12-IIIA, 2-IIIB, 8-IIIC1 and 4-IIIC2. Pathology 99/112 endometrioid and 23/112 other types. Radiotherapy patients were divided into two groups�Group 1 (70/112) consists of external beam irradiation (EBI) plus HDRBT (2 fractions of 5�6 Gy) and Group 2 (42/112) consists of HDRBT alone (4 fractions of 5�6 Gy). Toxicity evaluation RTOG scores for bladder and rectum, and the objective criteria of LENT-SOMA for vagina. Statistics bivariate analysis of Chi-square and Fisher exact tests.

  Results With a mean follow-up of 29.52 months (range 9.60�53.57) no patient developed vaginal-cuff relapse. In Group 1 early toxicity appeared in 9 % in rectum, 8.5 % in bladder (G1�G2) and 1.4 % in vagina (G1); late toxicity was present in 8.5 % in rectum (all G1�G2 but 1 G3) and in 25 % in vagina (all G1�G2 but one G4). In Group 2, 9.4 % developed G1�G2 bladder and 6.9 % acute vagina (G1�G2) toxicity. Only 2.3 % had a G1 rectal score and 6.9 % had G1�G2 as vaginal scores for late problems.

  Conclusions (1) Daily HDRBT using two fractions of 5�6 Gy after EBI and four fractions of 5�6 Gy as exclusive treatment was a safe regime. (2) Group 1 showed a higher incidence of late vaginal toxicity.