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Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Authors Sabater S, Andres I, Lopez-Honrubia V, Berenguer R, Sevillano M, Jimenez-Jimenez E, Rovirosa A, Arenas M

Received 28 March 2017

Accepted for publication 13 July 2017

Published 9 August 2017 Volume 2017:9 Pages 351—362

DOI https://doi.org/10.2147/CMAR.S119125

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 4

Editor who approved publication: Professor Nakshatri


Sebastià Sabater,1 Ignacio Andres,1 Veronica Lopez-Honrubia,1 Roberto Berenguer,1 Marimar Sevillano,1 Esther Jimenez-Jimenez,2 Angeles Rovirosa,3 Meritxell Arenas,4

1Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete, Albacete, 2Department of Radiation Oncology, Hospital Son Espases, Palma de Mallorca, 3Department of Radiation Oncology, Hospital Clinic, Barcelona, 4Department of Radiation Oncology, Hospital Universitari Sant Joan, Reus, Spain

Abstract: Endometrial cancer (EC) is one of the most common gynecological cancers among women in the developed countries. Vaginal cuff is the main location of relapses after a curative surgical procedure and postoperative radiation therapy have proven to diminish it. Nevertheless, these results have not translated into better survival results. The preeminent place of vaginal cuff brachytherapy (VCB) in the postoperative treatment of high- to intermediate-risk EC was given by the PORTEC-2 trial, which demonstrated a similar reduction in relapses with VCB than with external beam radiotherapy (EBRT), but VCB induced less late toxicity. As a result of this trial, the use of VCB has increased in clinical practice at the expense of EBRT. A majority of the clinical reviews of VCB usually address the risk categories and patient selection but pay little attention to technical aspects of the VCB procedure. Our review aimed to address both aspects. First of all, we described the risk groups, which guide patient selection for VCB in clinical practice. Then, we depicted several technical aspects that might influence dose deposition and toxicity. Bladder distension and rectal distension as well as applicator position or patient position are some of those variables that we reviewed.

Keywords:
endometrial cancer, vaginal cuff brachytherapy, rectum, bladder, technique

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