High-Dose-Rate Rotte 'Y' Applicator Brachytherapy for Definitive Treatment of Medically Inoperable Endometrial Cancer: 10-Year Results

Journal Article · Tue Jul 01 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.10.026· OSTI ID:21124317

Coon, Devin ^[1]; Beriwal, Sushil ^[1]; Heron, Dwight E ^[1]; Kelley, Joseph L; Edwards, Robert P; Sukumvanich, Paniti; Zorn, Kristin K; Krivak, Thomas C ^[2]

---

1. Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)
2. Division of Gynecologic Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA (United States)

Purpose: To assess the intermediate clinical outcomes of medically inoperable patients with endometrial cancer treated with definitive Rotte 'Y' applicator high-dose-rate brachytherapy (HDRB) over a 10-year period. Methods and Materials: Forty-nine inoperable patients were treated with HDRB from 1997 to 2007. Forty three (84%) were markedly obese (body mass index >35 kg/m{sup 2}). Thirty-one patients (63.3%) underwent two-dimensional treatment planning, whereas 18 patients (36.7%) underwent three-dimensional treatment planning. Thirty five of the patients (71.4%) were first treated with external beam radiotherapy (EBRT). For patients receiving EBRT in addition to HDRB, the median Y-applicator dose was 20 Gy in 5 fractions; for patients receiving HDRB alone it was 35 Gy in 5 fractions. All patients received two Y-applicator treatments per day. Results: Median follow-up time for all patients was 33 months. Acute HDRB toxicities were limited to Grade 1 and 2 occurring in 5 patients. One patient had a myocardial infarction. Four patients had late Grade 2 or 3 toxicity. Three patients had local recurrence (median time to recurrence, 16 months). The 3- and 5-year actuarial cause-specific survival rates were 93% and 87%, respectively; the overall survival rate was 83% and 42%, respectively, at 3 and 5 years. Conclusions: Twice-daily HDRB using a Y-applicator is a well-tolerated and efficacious regimen for the definitive treatment of medically inoperable patients with early-stage endometrial cancer. The recent incorporation of three-dimensional treatment planning has the potential to further decrease treatment morbidities.

• OSTI ID: 21124317
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 71; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
DISEASE INCIDENCE
DOSE RATES
MYOCARDIAL INFARCTION
NEOPLASMS
PATIENTS
PLANNING
TOXICITY