High-dose-rate intracavitary brachytherapy for non-palpable and non-visible recurrent vaginal stump tumors after hysterectomy

Purpose: The purpose of this study was to evaluate patients who were treated with high-dose-rate (HDR) intracavitary brachytherapy for non-palpable and non-visible recurrent vaginal stump that occurred after hysterectomy. Materials and Methods: This retrospective study included 11 patients aged 52–81 (median, 61) years. The HDR brachytherapy was performed using a remote after-loading system (RALS). The dose per fraction was planned at mainly 4 Gy/fraction, twice per week, for a total of 32 Gy. Results: CR and PR were diagnosed on cytology or visual examination in nine (82%) patients and in one (9%) patient, respectively. SD was noted in one (9%) patient. Isolated stump recurrence developed in five patients and the three-year LC rate was 53%. There was no severe acute and late toxicity. Conclusion: Local salvage is possible with a three-year LC rate of 53% with regard to non-palpable and non-visible limited vaginal recurrence of gynecological cancer that responds to HDR brachytherapy (4 Gy/fraction, total 32 Gy).

High-dose-rate intracavitary brachytherapy; Recurrent vaginal stump; Hysterectomy; Remote after-loading system; Gynecological cancer.

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