Brachytherapy in Endometrial Cancer

Abstract

Endometrial cancer is the most common gynecologic cancer in developed countries with the cumulative risk rate of 1.71%. Endometrial cancer standard treatment is surgery. But adjuvant radiotherapy may be recommended for patients in advanced age who have high-grade disease, deep myometrial invasion, LVSI positivity, risk factors such as large tumor diameter, lymph node invasion, and advanced stage disease. Brachytherapy is applied in two ways, namely intra-cavitary or interstitial radiation therapy. Intra-cavitary brachytherapy is the presence of a therapeutic radioactive isotope within the body space, for example, vaginal and intra-uterine brachytherapy. Radioactive isotopes are directly inserted within the tissue in interstitial brachytherapy as in the treatment of cervical or endometrial cancers that have reached the lateral walls. The intra-cavitary brachytherapy technique is the most commonly used technique in gynecologic oncology. Standard treatment cannot be performed in a group of patients due to their medical disorders and clinical performances. In these patients, definitive radiotherapy is applied for clinical stage 1 patients, neo-adjuvant therapy is applied to patients with local advanced stage disease and brachytherapy alone or radiotherapy with addition of EBRT is applied as palliative treatment in patients who have complaints such as bleeding and pelvic pain.