Preliminary clinical outcomes of patients treated with vaginal brachytherapy alone using multi-channel vaginal brachytherapy applicator in operated early-stage endometrial cancer.

BACKGROUND: Recommendations for adjuvant treatment for postoperative, early-stage endometrial cancer varies from observation through vaginal brachytherapy alone to pelvic radiation. While observation alone can lead to recurrence, external radiotherapy has increased morbidity. The aim of this study is to show our results with vaginal brachytherapy alone using a multichannel applicator for treatment of early-stage endometrial cancer. MATERIALS AND METHODS: Consecutive patients undergoing vaginal brachytherapy alone following surgery for early-stage endometrial cancer were examined. A Miami multichannel vaginal brachytherapy applicator was used to deliver HDR brachytherapy in 62 patients from May 2013 to June 2018. CT scan-based images guided planning. A dose of 5.5-6.5 Gy × 4 fractions was prescribed 5 mm from the surface of the applicator. RESULTS: At a median follow up of 19 months (6-48 months), 93% of patients treated were alive with no recurrence. Two patients had only local recurrence, and 1 was salvaged with external radiotherapy and chemotherapy. There was only one nodal failure and 2 distant failures. There was no grade 2 or higher vaginal, gastrointestinal or genitourinary toxicity. CONCLUSION: Vaginal brachytherapy alone using a multichannel applicator can be considered for early-stage endometrial cancers without compromising outcomes.

Chemo-radiation outcomes for esophageal cancer: A reflection from a tertiary cancer center on selection of patients for more aggressive therapy.

INTRODUCTION: Most esophageal cancer patients present with poor nutritional status and may not tolerate radical treatment. AIM: We aim to identify patients who are good candidates for chemo-radiation (CTRT). MATERIALS AND METHODS: Fifty-four patients treated with CTRT were followed up for a mean period of 28 months and factors affecting the outcome were analyzed along with the recurrence pattern. RESULTS: Forty-eight patients (88%) received CTRT and all completed treatment as scheduled. Eighteen (32%), 15 (27%) patients were alive with and without disease, respectively, at 28 months while 20 (37%) were dead. There was no statistically significant correlation between local failure and any of the factors like length, grade of the tumor, and chemotherapy received. CONCLUSION: Esophageal cancer patients present at an advanced stage and hence careful selection of patients for radical CTRT is very important for providing relatively longer disease-free interval. Equally important is the close monitoring of patients during treatment which helps in completing the planned treatment which translates into a better long-term outcome.