Evaluation of Organ-At-Risk (OAR) Sparing in Vaginal Cuff Boost Treatment for Endometrial Cancer using Stereotactic Body Radiotherapy (SBRT) and Brachytherapy

Postoperative radiotherapy (RT) followed by vaginal cuff brachytherapy boost is used to prevent recurrences in the vaginal cuff in endometrial cancer management [1]. 8-year vaginal cuff local control rates for patients with endometrial carcinoma were reported to be 85% with surgery alone,96 % with adjuvant pelvic RT alone and combined pelvic RT + brachytherapy has yielded a local control rate of 97.3% in the studies by Creutzberg et al. & Mandell et al. [2,3]. While improving local control, postoperative vaginal cuff boost radiotherapy may pose the risk of treatment related toxicity due to intimate association of critical organs with the high-dose region [4]. In the study by Macleod et al., complication rates were reported to be in the range of 8-23 % and 25-45% with postoperative vaginal vault brachytherapy alone and combined external pelvic RT + brachytherapy, respectively [5].