CASE REPORT: HDR INTERSTITIAL BRACHYTHERAPY AS A SALVAGE TREATMENT FOR RECURRENT ENDOMETRIAL CARCINOMA

A patient with recurrent endometrial carcinoma who received limited surgery and HDR brachytherapy as a salvage treatment is evaluated. Urethra was surrounded by the recurrent mass, which was limited to the vagina, next to the pubic bone. Pelvic exenteration was offered as a salvage treatment however, the patient did not accept surgery for its morbidity. After wide resection, due to previous external radiotherapy, brachytherapy alone, including 3 intracavitary and 4 interstitial fractions was applied. Interstitial brachytherapy target volume was 2 cm around the preoperative tumor mass. Fraction dose was 400 cGy to the target. Total target, rectal and bladder doses were 2800, 2301 and 1987 cGy respectively. Wide resection plus brachytherapy which provide higher dose in tumor and under tolerance doses in normal tissue, can be an alternative salvage treatment for selected recurrent endometrial carcinoma patients who present with lesion limited in vagina, and received external radiotherapy.

Keywords: recurrent endometrial carcinoma, high dose rate interstitial brachytherapy