Do you give vaginal cuff brachytherapy and/or whole pelvis, for patients with Stage III endometrial adenocarcinoma?
Depends on the substage and extent of surgical staging:
- Stage IIIa serosa: I give pelvic RT alone often following chemotherapy. I would also add vag brachy in cases of cervical stromal invasion.
- Stage IIIa adnexae. Same as (1).
- Stage IIIb. I give pelvic RT plus vaginal brachy often following chemot...
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Most would give pelvic RT for stage III disease either concurrently like RTOG, sequential, or sandwiched with chemotherapy. The impact of pelvic RT is the subject of the ongoing GOG 258 study which allows a brachy boost.
The value of adding brachytherapy after EBRT is based on recurrence patterns and...
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I would recommend pelvic RT + vaginal cuff brachy.
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Pelvic IMRT to 45 Gy and cuff brachytherapy. We typically do sandwich with sequential for extensive disease patients.
Addendum: With 10 year follow up of 0258 and with the planned addition of immunotherapy in the future, we are moving away from sandwich and toward sequential therapy. The prevention ...
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Agree with everything above. There have been several Mednet threads on the value of and indications for adding brachy boost to EBRT for endometrial. For more info, I'd recommend doing a search in theMednet.
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