The role of vaginal brachytherapy in stage I endometrial serous cancer: a systematic review

Valentina Lancellotta, Francesca De Felice, Lisa Vicenzi, Alfredo Antonacci, Valentina Cerboneschi, Sara Costantini, Daniela di Cristino, Luca Tagliaferri, Annamaria Cerrotta, Andrea Vavassori, Sergio Gribaudo, Alessandro Colombo, Francesco Lucà, Raffaele Barbara, Monica Mangoni, Francesco Marampon, Daniela Musio, Filippo Bellati, Francesco Torcia, Vincenzo Tombolini, Mattia Falchetto Osti, Vitaliana De Sanctis
Journal of Contemporary Brachytherapy 2020, 12 (1): 61-66

Purpose: Serous adenocarcinoma (uterine serous carcinoma - USC) is a rare and aggressive histologic subtype of endometrial cancer, with a high-rate of recurrence and poor prognosis. The adjuvant treatment for stage I patients is unclear. The purpose of this study was to evaluate the outcomes of stage I USC treated exclusively with chemotherapy plus vaginal brachytherapy (VBT).

Material and methods: A systematic research using PubMed, Scopus, and Cochrane library was conducted to identify full articles evaluating the efficacy of VBT in patients with stage I USC. A search in was performed in order to detect ongoing or recently completed trials, and in PROSPERO for searching ongoing or recently completed systematic reviews.

Results: All studies were retrospective and 364 of evaluated patients were found. The average local control was 97.5% (range, 91-100%), the disease free-survival was 88% (range, 82-94%), the overall survival was 93% (range, 72-100%), the specific cancer survival was 89.4% (range, 84.8-94%), and the G3-G4 toxicity was 0-8%.

Conclusions: These data support the concept that in adequately selected patients, VBT alone may be a suitable radiotherapy technique in women with stage I USC who underwent surgical staging and received adjuvant chemotherapy.

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