S61
Brachytherapy - Gynaecology
ESTRO 2026
Results: A total of 20 patients was included. Most patients were initially diagnosed with endometroid endometrial cancer (70%) and FIGO stage I-II disease (75%), Lymph vascular space invasion (LVSI) was present in four patients (20%). Most tumours were grade 1-2 (60%). Median age at diagnosis was 64 (range 51-76). Primary treatment included hysterectomy with or without lymph node dissection in all patients. Adjuvant treatment was given in 9 patients (45%) (vaginal brachytherapy (n=2), EBRT (n=3) or chemotherapy (n=4)). Median time to recurrence was 28 months (range 1-89 months). Most patients (80%, n=15) presented with vaginal vault recurrence, one patient presented with both vaginal vault and lymph node recurrence, one with vaginal vault recurrence and a solitary pulmonary metastasis, one with a para-aortic lymph node recurrence, two with recurrence at the distal vagina of whom one also had a lymph node recurrence. In 13 patients (65%) EBRT and a brachytherapy boost was given. Brachy monotherapy (n=2), EBRT only (n=1), resection followed by adjuvant brachytherapy (n=2) or EBRT and brachytherapy (n=1) and induction chemotherapy, resection and EBRT combined with brachytherapy (n=1) where other used modalities. Brachytherapy was individualized according to tumour extent and was given either by interstitial (IS) (N=1), intracavitary (IC) (N=3) or combined techniques (IC/IS). Median EQD2 ( α / β 10) to the macroscopic tumour (D90) was 77,2 Gy (range 48- 87 Gy) (table 1). In all patients local control was achieved, only one had a locoregional recurrence at 12 months. Eleven patients (55%) developed distant metastasis after a median follow up of 20 months. Median follow up after treatment was 45 months (range 21-117 months). The 5-year overall survival was 57% (fig 1).
Conclusion: In our series, with 5/20 previously irradiated patients, high dose radiotherapy including brachytherapy yields a very high probability of local control with a substantial 5-year survival of 57 %. However, a substantial percentage will present with distant recurrence. Keywords: recurrent, endometrial cancer, brachytherapy Clinical audit of combined intracavitary interstitial brachytherapy using Utrecht applicator in locally advanced cervical cancer Aparna Mullangath Prakasan 1 , Aswin Kumar 1 , Susan Mathews 1 , John Joseph 1 , Raghukumar Paramu 2 , Sarika V Menon 2 , Jagathnath Krishna 3 , Francis V James 1 1 Radiation Oncology, Regional Cancer Centre, Thiruvanathapuram, India. 2 Medical Physics, Regional Cancer Centre, Thiruvanathapuram, India. 3 Biostatitics and epidemiology, Regional Cancer Centre, Thiruvanathapuram, India Purpose/Objective: In 15-20% of advanced cervical cancer patients with lateral parametrial involvement and asymmetrical tumors, the dose coverage delivered by intracavitary( IC) applicators may be inadequate1. The combination of image-guided treatment planning with the Digital Poster 2251 intracavitary+interstitial (IC+IS) approach has resulted in improvements in dose-volume histogram (DVH) parameters and clinical outcome 2,3. This study aims to evaluate the clinical outcome in locally advanced cervical cancer after CT-based image-guided brachytherapy with combined IC+IS technique using the Utrecht applicator. Material/Methods: Cervical cancer patients treated with CT-based brachytherapy using the Utrecht applicator between 2019 and 2023 were retrospectively analyzed. All received EBT to the pelvis at 45-46 Gy in 1.8 - 2 Gy per
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