Evaluating the Incidence Rate of an Accelerated Short Course High Dose Rate Intravaginal Brachytherapy Complications in Patients with Endometrial Cancer

Document Type : Research Articles


1 Radiation Oncology Research Center (RORC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.

2 Physics Department of Radiation Oncology, Tehran University of Medical Sciences, Tehran, Iran.

3 Recombinant Proteins Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran.

4 Western University of Health Sciences, Pomona, CA.


Background: Brachytherapy in treatment of endometrial cancer patients is growing and therefore, evaluation of
more feasible schedule has become of great importance. The purpose of current study was to evaluate the complications
of accelerated short course high dose rate intravaginal brachytherapy (HDR IVB), a new brachytherapy approach
which is a more feasible treatment option in developing countries. Method: From 2017 to 2018, 54 patients diagnosed
with endometrial cancer and FIGO stages IA to IIB who underwent total abdominal hysterectomy with a bilateral
salpingo-oophorectomy were enrolled in present study. They were treated with a total dose of 25 Gy in 5 fractions
which was prescribed daily. A dose of 5 Gy was prescribed at a depth of 0.5 cm in the upper third and middle third
of vagina. Adverse effects related to organs at risk consist of bladder, vagina and rectum were documented based on
the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0). Results: The accelerated short course
HDR IVB was well tolerated and no grade 3 or higher toxicities was reported for patients during the follow up period.
There were no chronic rectal toxicities and only one patient showed chronic urinary toxicities. However, the incidence
rate of vaginal toxicities at the end of 4-month and 8-month follow up periods was higher than acute toxicities and
significantly lower in elderly group compared to younger group. Conclusion: Overall, the accelerated HDR IVB was
safe and was well tolerated in endometrial cancer patients and the incidence rate of undue complications were equal,
if not less, in elderly patients compared to the younger ones.


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