Comparison of high-dose-rate and low-dose-rate brachytherapy in the treatment of endometrial carcinoma.
OBJECTIVE
To compare the outcomes for endometrial carcinoma patients treated with either high-dose-rate (HDR) or low-dose-rate (LDR) brachytherapy.


METHODS
This study included 1,179 patients divided into LDR (1,004) and HDR groups (175). Patients with International Federation of Gynecology and Obstetrics (FIGO) surgical Stages I-III were included. All patients were treated with postoperative irradiation. In the LDR group, the postoperative dose applied to the vaginal cuff was 60-70 Gy surface doses to the vaginal mucosa. The HDR brachytherapy prescription was 6 fractions of 2 Gy each to a depth of 0.5 cm from the surface of the vaginal mucosa. Overall survival, disease-free survival, local control, and complications were endpoints.


RESULTS
For all stages combined, the overall survival, disease-free survival, and local control at 5 years in the LDR group were 70%, 69%, and 81%, respectively. For all stages combined, the overall survival, disease-free survival, and local control at 5 years in the HDR group were 68%, 62%, and 78%, respectively. There were no significant differences in early or late Grade III and IV complications in the HDR or LDR groups.


CONCLUSIONS
Survival outcomes, pelvic tumor control, and Grade III and IV complications were not significantly different in the LDR brachytherapy group compared with the HDR group.
Fayed
Alaa
A
Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO 63110, USA.
Mutch
David G
DG
Rader
Janet S
JS
Gibb
Randall K
RK
Powell
Matthew A
MA
Wright
Jason D
JD
Elnaqa
Issam
I
Zoberi
Imran
I
Grigsby
Perry W
PW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D012044:Regression Analysis; D016896:Treatment Outcome