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165 An audit of the use of vaginal brachytherapy in endometrial cancers
  1. Bhargavi Ilangovan,
  2. Ganapathy Raman and
  3. S Ayyappan
  1. Madras Cancer Care Foundation


Introduction/Background Vaginal Brachytherapy is an effective treatment modality to prevent local recurrence in endometrial cancers. We did an audit of the Endometrial cancer cases treated by an oncology group practice over a period of 5 years to assess the use of VBT.

Methodology The data of 106 patients treated for endometrial cancers between 2014 and 2019 by an oncology group across 2 tertiary care centres was retrospectively analysed.

The indications of vaginal brachytherapy, number of fractions, dose per fraction, prescription points, vaginal stenosis on follow up and use of vaginal dilators were the variables collected and were entered in an excel sheet.

Results A total of 106 patient data was entered and analysed. The mean age of the patients was 60 years. The radiotherapy details were available for 84 patients. Of the 84 patients analysed, 59 patients (70%) received adjuvant Vaginal Brachytherapy, while 25(30%) did not. Of the patients who received VBT, 32 (54.2%) patients received VBT as a boost after Pelvic RT (figure 1).

Abstract 165 Figure 1

Percentage of patient receiving only VBT and VBT boost after pelvic RTonly VBT:The stage distribution of the patients who underwent only VBT was as follows (figure 2 and table 1).

Abstract 165 Table 1

The stagewise and grade wise numbers

VBT BOOST: Among the 32 patients who received vaginal Brachytherapy as a boost after Pelvic RT, only 4(12.5%) patients had cervix involvement. Lower uterine segment was involved in 12 patients.

The EBRT dose was 45- 50 Gy in 25 to 28 fractions.

The common dose fractionations for VBT were 25 Gy/5 #, 24 Gy/4# and 21 Gy/3#; weekly #s. Majority of the prescriptions were to the vaginal mucosa.

There was no standard documentation of vaginal shortening. The use of vaginal dilators was scarce.

Conclusion There was a substantial percentage of women who received VBT in the low risk group. A survey among the consultants showed that poor follow up and the lack of patient awareness, as the reason behind this. Patients operated at peripheral centres ended up having VBT in the low risk group. Lower uterine segment involvement seems to be a factor tipping the decision towards VBT. The use of VBT boost after Pelvic Radiotherapy, has been seen in about 88% of the patients without the involvement of cervix, warranting a national consensus guideline for these tumours.

Disclosures We disclose no conflict of interest.

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