@Article{Huddleston2015,
journal="Journal of Contemporary Brachytherapy",
issn="1689-832X",
volume="7",
number="2",
year="2015",
title="Original paperThe impact of a vaginal brachytherapy boost to pelvic radiation in stage III endometrial cancer",
abstract=" Purpose : We investigate the use and impact of a vaginal brachytherapy boost (VBB) after pelvic radiotherapy for stage III endometrial adenocarcinoma on vaginal and pelvic control.    Material and methods : One hundred patients treated from 1998-2011 with surgery and adjuvant therapy with or without a VBB were included. Variables examined were grade, stage, lymphovascular space invasion (LVSI), vaginal involvement (VI), cervical stromal involvement (CSI), myometrial invasion (MI), and a VBB. Failure was scored as vaginal, or pelvic. Fisher’s exact test assessed association between variables with vaginal and pelvic control.    Results:   With a median follow up of 43 months, 31% were stage IIIA, 6% stage IIIB, and 63% stage IIIC. Thirty-eight (38%) received pelvic radiotherapy alone, and 62% received adjuvant chemotherapy. Of the 100 patients, 82 were treated with a VBB, 10 were not treated with a VBB, and 8 were not treated with RT. Of the 82 patients who received a VBB, 5 failed in the vagina with vaginal and pelvic control rates of 94% and 92%. The impact of VB reached borderline significance with its impact on pelvic control, 92% vs. 70% (p = 0.056), and did not affect vaginal control, 94% and 90% (p = 0.50). Neither tumor grade, LVSI, CSI, stage, nor LVSI (p > 0.05) statistically significantly impacted vaginal control.    Conclusions : There are no clinical guidelines for the use of a VBB in stage III endometrial cancer. The majority of our patients were treated with a VBB and experienced excellent pelvic and vaginal control. The presence of traditional adverse features did not negatively impact control in our patient cohort. However, the role of a VBB needs further investigation to understand the incremental benefit beyond pelvic RT.",
author="Huddleston, Adam
and Zhen, Sally
and Qi, Lihong
and Rash, Dominique
and Leiserowitz, Gary
and Mayadev, Jyoti",
pages="122--127",
doi="10.5114/jcb.2015.50877",
url="http://dx.doi.org/10.5114/jcb.2015.50877"
}