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Vaginal Brachytherapy May Be Best for Endometrial Cancer

Compared with external radiotherapy, it results in fewer side effects, better quality of life

FRIDAY, March 5 (HealthDay News) -- In patients with high-intermediate-risk endometrial cancer, vaginal brachytherapy is just as effective as pelvic external beam radiotherapy for prevention of vaginal recurrence, has fewer toxic effects and leads to improved quality of life, according to a study in the March 6 issue of The Lancet.

Remi A. Nout, M.D., of the Leiden University Medical Center in the Netherlands, and colleagues conducted a study of 427 stage I or IIA endometrial cancer patients recruited from 19 Dutch radiation oncology centers, of whom 214 underwent pelvic external beam radiotherapy and 213 had vaginal brachytherapy. Vaginal recurrence was the primary end point of the study, and the participants were followed up for a median 45 months.

In the vaginal brachytherapy group there were three recurrences, while there were four in the external beam radiotherapy group, and disease-free and overall survival rates were similar for the two groups, the researchers found. However, only 12.6 percent of patients in the vaginal brachytherapy group experienced acute grade 1 to 2 gastrointestinal toxicity, compared to 53.8 percent in the external beam radiotherapy group.

"Vaginal brachytherapy is very effective in ensuring local control, keeping to a minimum the risk of vaginal recurrence," the authors write. "Vaginal brachytherapy should be the adjuvant treatment of choice for patients with endometrial carcinoma of high-intermediate risk."

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