Three or Four Fractions of 4–5 Gy per Week in Postoperative High-Dose-Rate Brachytherapy for Endometrial Carcinoma

Purpose To evaluate the results of high-dose-rate brachytherapy (HDRBT) using a schedule of three or four fractions per week, when possible, in 89 patients on local control and toxicity in postoperative treatment of endometrial carcinoma. The effect of the overall HDRBT treatment time (OTT) on toxicity was also evaluated. Patients and Methods Federation Internationale de Gynecologie Obstetrique Stage: 24 IB, 45 IC, 4 IIA, 6 IIB, 4 IIIA, 2 IIIB, and 4 IIIC. Radiotherapy: Group 1—67 of 89 patients received external beam irradiation (EBI; 44–50 Gy) plus HDRBT (3 fractions of 4–6 Gy); Group 2—22 of 89 patients received HDRBT alone (6 fractions of 4–5 Gy). OTT: Group 1—HDRBT was completed in a median of 5 days in 32 patients and in >5 days in 35; Group 2—HDRBT was completed in t test, chi-square test, and receiving operator curves. Results With a mean follow-up of 31 months (range, 6–70), 1 of 89 patients had vaginal relapse. Early toxicity appeared in 8 of 89 (9%) patients and was resolved. Late toxicity appeared in 13/89 (14%): vaginal nine Grade 1, three Grade 2, one Grade 4; bladder two Grade 2; rectal three Grade 1, one Grade 2. No differences were found in relation to OTT in Groups 1 and 2. Mean BED was 88.48 Gy in Group 1 and 165.28 Gy in Group 2. Cases with Grade 2 late vaginal toxicity received >75 Gy after EBI and >165 Gy in Group 2. Conclusions Three fractions of 4–5 Gy in 3–5 days after EBI or 6 fractions in