Purpose: Surgery is the golden standard of treatment of endometrial carcinoma. The risk of central or vaginal recurrences justifies adjuvant treatment.
Methods: Brachytherapy for endometrial adenocarcinoma is given commonly as pre- or post-operative treatment. In case of medical contra-indications for surgery brachytherapy can be applied as the only treatment. Experience of the anticancer center Alexis Vautrin in Nancy of the years 1975 to 1988 is evaluated. Iridium-192 low-dose-rate (LDR) wires were used.
Results: Pre-operative brachytherapy was given with a vaginal mould applicator to 580 patients. The dose was 50 Gy at 0.5 cm below the surface of the vagina. The locoregional control rate was 93% after 5 years and the 5-year survival 82%. 139 patients received radiotherapy alone and no surgery. LDR-brachytherapy was given the upper third of the vagina and endometrium with an "umbrella" applicator. The locoregional control rate was 83% after 5 years and the survival rate 55%. 117 patients received a post-operative brachytherapy of the vagina. The locoregional control rate was 93% after 10 years and the survival rate 65%.
Conclusion: A pre- and post-operative radiotherapy results in a reduction of the vaginal relapse rate. The LDR afterloading technique with primary radiotherapy of endometrial adenocarcinoma leads to a locoregional control slightly interior. The treatment results compare favourably with the best of the literature.
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