When do you use a vaginal cuff boost with pelvic RT for stage II endometrial cancer?

Topics: Radiation Oncology • Gynecologic Cancers • Endometrial Cancer

For the management of stage II endometrial cancer, NCCN says pelvic RT and/or vaginal brachytherapy. Do you ever add vaginal cuff boost to pelvic RT, and if so, what factors do you consider when you combine treatment?

Answer from: Radiation Oncologist at Academic Institution

Most prospective studies studying the role of external beam in endometrial cancer have treated patients with pelvic radiation (46/2 Gy or 50.4/1.8 Gy) without any brachytherapy. These studies have reported very low rates (2-3%) of in field failure in the radiation arms, so recommending external beam...

Comments

Radiation Oncologist at Baptist Health Fort Smith
How do you sequence the external beam and brachyth...

Radiation Oncologist at Johns Hopkins
We typically start the brachy boost immediately af...

Answer from: Radiation Oncologist at Academic Institution

I agree entirely with @Ann H. Klopp. I will add that the patients receiving external beam RT today tend to have a higher risk profile than those studied in the past, because most intermediate risk patients are now treated with vaginal cuff RT only.

Answer from: Radiation Oncologist at Academic Institution

To answer whether stage II patients are ever treated with VBT alone, it's not a boards answer as it's not supported by randomized data, but we have done it based on this multi-institutional analysis out of Loyola: https://www.ncbi.nlm.nih.gov/pubmed/29885996 Requirements are that the patient un...

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