What factors do you use to determine whether to add brachytherapy to EBRT for IIIC endometrial cancer?
Current NCCN guidelines suggest that vaginal brachytherapy is optional, and there may be concern for over-treatment locally given competing risk of distant metastatic disease.
Answer from: Radiation Oncologist at Community Practice
My philosophy is to use 45 Gy in 25 fractions of EBRT followed by two fractions HDR boost.
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Answer from: Radiation Oncologist at Academic Institution
Nothing in the way of prospective data, but an NCDB analysis showed a survival benefit in adding brachy to EBRT for patients with cervical gland/stromal involvement
Answer from: Radiation Oncologist at Academic Institution
We would tailor the external beam dose and brachytherapy to the factors identified on the pathology report. IIIC covers many situations.
For a tumor up at the fundus, and grade 1 we might treat with external beam therapy alone and omit the brachytherapy.
If there was evidence of parametr...