Patients who had vaginal recurrence of endometrial cancer generally benefitted from treatment with vaginal brachytherapy, according to a study recently published in Brachytherapy.
Brachytherapy is the localized delivery of radiation therapy that works by killing cancer cells. It allows for a more targeted approach towards the destruction of cancer cells while sparing healthy tissue. Vaginal recurrence among patients with endometrial cancer who have never had radiotherapy can generally be treated with vaginal brachytherapy and pelvic external beam radiotherapy.
Investigators sought to better understand the evidence behind this treatment strategy in endometrial cancer vaginal recurrence. Specifically, they wanted to evaluate patient outcomes and toxicity among patients who have received brachytherapy guided by magnetic resonance imaging (MRI).
This led researchers to look into the clinical data of patients with endometrial cancer who received this procedure between November 2025 and November 2023 at a single center. All these patients had laboratory evidence of vaginal recurrence and received brachytherapy with curative intent. Patients who already had distant metastases were excluded from this study.
Read more about endometrial cancer causes and risk factors
The clinical data of 56 patients were selected for final analysis. Almost all (94%) were diagnosed with endometrial endometrial adenocarcinoma. Vaginal recurrence developed over a median of 25 months following surgery. Thirty-nine (70%) patients had interstitial brachytherapy (ie, the delivery of radiation into the tumor via a device), while 17 (30%) had intracavitary brachytherapy (ie, the delivery of radiation via insertion of a device into the vaginal cavity).
Eleven patients (20%) developed a second cancer recurrence across a median follow-up period of 39.5 months. Six patients died from cancer recurrence. The 2-year local failure (LF) (ie, cancer returning to the original site), disease-free survival (DFS), and overall survival (OS) were 5.9%, 83%, and 94% respectively. A few late toxicities occurred in this cohort of patients, with the highest being grade 2.
“In this retrospective study, we demonstrate that patients with vaginal recurrence of endometrial cancer treated with MRI-guided brachytherapy had favorable local control, DFS, OS and toxicity profile,” the authors of the study wrote.
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