Title: Adjuvant Therapy in Endometrial Carcinoma: Comparing Outcomes of Low Dose Rate (LDR) and High Dose Rate (HDR) Brachytherapy
Authors: Dr Poojar Sridhar, Dr Naveen T, Dr Rahul Loni, Dr Surekha Goyal, Dr Lokesh V, C R Vijay
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.194
Abstract
Background: Endometrial cancer is the sixth most common cancer in women worldwide, with 320,000 new cases diagnosed in 2012 with good survival outcomes with adequate treatment. Studies have proven that brachytherapy with or without external beam radiotherapy plays an important role in adjuvant therapy of endometrial cancer. Several studies have been done comparing HDR and LDR brachytherapy in cervical cancer, but very few have been done in endometrial cancer. Thus, we have undertaken this study to compare the outcomes of LDR and HDR brachytherapy in endometrial cancer in terms of overall survival and toxicities.
Materials and Methods: 67 cases of endometrial cancer treated in our institute between 2007 to 2014 were retrospectively analysed. All the patients underwent surgery in the form of radical hysterectomy and pelvic lymph node dissection. Depending on the histopathological findings, patients were stratified into risk categories. Depending on which adjuvant chemoradiation followed by brachytherapy or only brachytherapy was given as indicated.
Results: After a median follow-up of 97 months, outcomes were analysed comparing HDR and LDR arm. It was found that both groups had comparable outcomes in terms of overall survival and associated toxicities.
Conclusion: HDR brachytherapy showed comparable results to LDR brachytherapy in terms of overall survival and toxicity. Hence, we recommend that in present era, with advanced techniques of application and optimization, HDR brachytherapy is a preferable technique of treatment.
Keywords: External beam radiotherapy, High dose rate brachytherapy, Low dose rate brachytherapy, Radical hysterectomy.
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