One-week vaginal brachytherapy schedule as exclusive adjuvant post-operative treatment in intermediate- and high-intermediate-risk endometrial cancer patients.
Purpose
The aim of the study was to report survival outcomes and toxicities incidence by using one-week vaginal brachytherapy (VBT) schedule in intermediate- and high-intermediate-risk endometrial cancer patients.


Material and methods
One hundred and eight patients were treated with exclusive high-dose-rate (HDR) brachytherapy short schedule (7 Gy/fraction/every other day/1 week). Acute and late rectal, urinary, and vaginal toxicities were recorded according to radiation therapy oncology group (RTOG) scores and late effects normal tissue task force - subjective, objective, management, analytic (LENT-SOMA) scores, respectively. Overall survival (OS), cause specific survival (CSS), and disease-free survival (DFS) were evaluated.


Results
Median follow-up was 44 months (range, 6-117 months). The 5-year OS, CSS, and DFS rates were 92.7%, 96.4%, and 89.5%, respectively. Seven of 108 (6.5%) patients relapsed after a median time of 31 months (range, 5-56 months). Death occurred in 6 patients. Four patients died for intercurrent causes without an evidence of disease. Acute bladder toxicity G1-G2 was reported in 11 of 108 (10%) patients, vaginal toxicity G1-G2 in 6 of 108 (5.5%), and gastrointestinal toxicity was observed in 3 of 108 (3%) patients. Late bladder and gastrointestinal G1 toxicities were reported in 4 of 108 (4%) and 1 of 108 (1%) patients, respectively. Late vaginal toxicity (G1-G2) was recorded in 3 of 108 (3%) cases. No grade 3-4 bladder, vaginal, and gastrointestinal toxicities were noted.


Conclusions
Exclusive short course adjuvant VBT is an effective treatment in patients with early-stage endometrial cancer and provides good outcomes in terms of disease local control and DFS, with low rates of toxicity profile.
['De Sanctis|Vitaliana|V|', 'Musio|Daniela|D|', 'De Felice|Francesca|F|', 'Marampon|Francesco|F|', 'Valeriani|Maurizio|M|', 'Bonome|Paolo|P|', 'Anzellini|Dimitri|D|', 'Facondo|Giuseppe|G|', 'Vullo|Gianluca|G|', 'Massaro|Maria|M|', 'Di Staso|Mario|M|', 'Bonfili|Pierluigi|P|', 'Chalaszczyk|Agnieszka|A|', 'Gravina|Giovanni Luca|GL|', 'Tombolini|Vincenzo|V|', 'Osti|Mattia Falchetto|MF|']
brachytherapy endometrial cancer survival toxicity local recurrence vaginal vault