American Brachytherapy Society recurrent carcinoma of the endometrium task force patterns of care and review of the literature. Brachytherapy 2017;16(6):1129-1143
Date
09/11/2017Pubmed ID
28888417DOI
10.1016/j.brachy.2017.07.012Scopus ID
2-s2.0-85028747582 (requires institutional sign-in at Scopus site) 28 CitationsAbstract
PURPOSE: The purpose of this American Brachytherapy Society task force is to present a literature review and patterns of care by a panel of experts for the management of vaginal recurrence of endometrial cancer.
METHODS AND MATERIALS: In 2016, the American Brachytherapy Society Board selected a panel of experts in gynecologic brachytherapy to update our current state of knowledge for managing vaginal recurrence of endometrial cancer. Practice patterns were evaluated via an online survey and clinical updates occurred through a combination of literature review and clinical experience and/or expertise.
RESULTS: There are various retrospective series of patients treated with radiation for vaginal recurrence of endometrial cancer, which include a varied group of patients, multiple treatment techniques, and a range of total doses and demonstrate a wide scope of local control and overall survival outcomes. In the era of image-guided brachytherapy, high local control rates with low significant late-term morbidities can be achieved. Lower rates of local control and higher late-term toxicity are reported in the retreatment setting. In patients with no previous history of radiation treatment, external beam radiation therapy followed by brachytherapy boost should be used. There are varying practices with regard to the definition and appropriate doses of both the high-risk clinical target volume and the intermediate-risk clinical target volume in the setting of vaginal recurrence of endometrial cancer. There are limited data to provide appropriate dose constraints for some organs at risk with the majority of guidance taken from the definitive cervical cancer literature.
CONCLUSIONS: A summary of literature and expert practice patterns for patient selection, dose recommendations, and constraints are provided as guidance for practitioners.
Author List
Kamrava M, Beriwal S, Erickson B, Gaffney D, Jhingran A, Klopp A, Park SJ, Viswanathan A, Yashar C, Lin LAuthor
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Advisory CommitteesBrachytherapy
Chemotherapy, Adjuvant
Endometrial Neoplasms
Female
Humans
Neoplasm Recurrence, Local
Patient Selection
Professional Practice
Radiotherapy Dosage
Retrospective Studies
United States
Vaginal Neoplasms
