Combined radiation therapy of endometrial cancer using a three-channel applicator

A new method of brachytherapy using a three-channel applicator with two-positional location of HDR radioactive sources has been implemented for treatment of endometrial cancer. This intracavitary radiation therapy method allows to radiate the tumor with an optimum and homogenous dose. From June 1996 to April 1998, 26 patients with endometrial cancer have been treated with the three-channel applicator. Stage IA was diagnosed for 3 patients, IB-10, II-7 and III-6. All patients received external beam RT, followed by brachytherapy. External beam RT was performed with symetrically opposed pelvic fields. The dose administered to the whole pelvis was 16-20 Gy applied in 5 fractions of 2,0 Gy per week. For most patients an external irradiation boots was administered to both parametria at a dose 30-50 Gy. The intracavitary Co-60 therapy was administered by a three-channel applicator and delivered a dose of 10 Gy par application. It has been used 5 fractions. Total dose of the dosimetry points of the uterus was between 70 and 80 Gy. After treatment complete regression of tumor was found for 19 patients and partial regression for 7 patients. Recurrence within a two year period occurred for three patients. Early Grade 1 radiation reactions developed in only three patients. During a two year period three were no late treatment complications. The short observation time did not allow for estimation and comparison of the treatment results. But a 88.9% two years survival rate and a 80% disease free survival rate, with a small number of radiation reactions prove a successful method. (Full text)