title: Treating the vaginal vault in carcinoma of the endometrium using the Buchler afterloading system.
abstract: The advent of high-dose-rate afterloading intracavitary radiotherapy has implications for both staff safety and the possibility of convenient, outpatient-based treatment for the patient. We have carried out a retrospective analysis of its use with high-activity iridium 192 and the Buchler machine to treat the vaginal valut in patients with adenocarcinoma of the endometrium, most of whom also received external-beam radiotherapy to the pelvis. We have compared the survival, complication and local control rates with a comparable group of historical controls treated with low-dose-rate intracavitary caesium ovoids. Complication rates, which included vaginal stenosis not volunteered by the patient, were 16% (95% confidence intervals 6-26%) in the study group and 28% (95% confidence intervals 17-41%) in the control group, with no serious complications requiring surgery. The actuarial survival was 92% at 5 years in the study group, and 94% at 5 years in the control group. Local control was 94% at 5 years in the control group and 98% at 5 years in the study group. The authors suggest that the use of high-dose-rate intracavitary radiotherapy, with the Buchler afterloading system, for vaginal vault irradiation in carcinoma of the endometrium is a convenient, safe and quick method, which does not necessitate admission or sedation of the patient. In addition it provides complete radiation protection for staff.
authors.affiliation: Department of Clinical Oncology, Hammersmith Hospital, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Thomas
authors.forename: D G
authors.initials: DG
authors.lastname: Pickering
authors.forename: P
authors.initials: P
authors.lastname: Dunn
authors.forename: K C
authors.initials: KC
authors.lastname: Kam
authors.forename: J S
authors.initials: JS
authors.lastname: Stewart
authors.forename: H E
authors.initials: HE
authors.lastname: Lambert
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D016889:Endometrial Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D014621:Vagina / Q000528:radiation effects
chemical_list: D007496:Iridium Radioisotopes