Article Text

Download PDFPDF
673 Electronic brachytherapy in gynecologic oncology – first experience from Bulgaria
  1. Angel Yordanov1,
  2. Virginia Payakova2,
  3. Desislava Hitova-Topkarova2,
  4. Desislava kostova-Lefterova2,3,4,
  5. Mariela Vasileva-Slaveva5,
  6. Stoyan Kostov6,7,
  7. Marin Valkov2,
  8. Ilko Iliev1,
  9. Konstantina Karakadieva1 and
  10. Nikolay Mutkurov8
  1. 1Department of Gynecologic Oncology, Medical University Pleven, Pleven, Bulgaria
  2. 2Department of Radiation Oncology, Medical University – Pleven, Pleven, Bulgaria
  3. 3National Cardiology Hospital, Sofia, Bulgaria
  4. 4Aleksandrovska University Hospital, Sofia, Bulgaria
  5. 5Department of Breast Surgery, Shterev Hospital, Sofia, Bulgaria
  6. 6Research Institute, Medical University Pleven, Pleven, Bulgaria
  7. 7Department of Gynecology, Hospital ‘Saint Anna’, Medical UniversityProf. Dr. Paraskev Stoyanov’, Varna, Bulgaria
  8. 8Department of Radiation Oncology, Complex Oncology Center, Burgas, Bulgaria


Introduction/Background Over one million new cases of cervical and endometrial cancers were diagnosed in 2020 and this is 10% of all womens’malignancies.The treatment of gynecologic cancers is multidisciplinary, depends to the individual patient risk and prognostic factors. Surgery, chemotherapy, external beam radiotherapy (EBRT), and brachytherapy (BT) can be recommended alone or combined.

The objective of this study is to investigate whether electronic brachytherapy (EBT) is alternative to conventional brachytherapy (BT) in terms of therapeutic effect and toxicity in patients with oncogynecological diseases.

Methodology Patients selection includes histologically proven endometrial cancer or cervical cancer who have undergone radical hysterectomy (RH) and pelvic lymph node dissection and who are generally subject to adjuvant BT alone or after external beam radiotherapy (EBRT). For EBT we use mobile system XoftAxxent with low-energy source 50kV X-ray tube (1mm size) and Brachycare treatment planning system (TPS). The prescribed physical dose is in between 10–21 Gy to 5 mm depth to the vaginal cuff in 2 to 3 fractions. Early toxicity was scored with the Common Terminology Criteria for Adverse Events version 5.0.

Results Our own dosimetric and clinical data are comparable to published world experience. We reported early toxicity after completed course of EBT, 21 patients reached 1 month follow-up and 19 patients -3 months. At the first month we reported - 4 G1 and 2 G2 events which is 19% and 9.5% of all patients after RH and vaginal EBT, respectively. For 3-month follow-up we had 3 events G1 (15,8%) and 2 G2 (10.5%) among patients, who underwent RH + vaginal EBT.

Conclusion EBT can be safe and reliable alternative to 192Ir HDR BT in the treatment of gynecological cancer. It has the potential to make BT accessible in regions where conventional BT is not available.

Disclosures The authors have no relevant financial or non-financial interests to disclose.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.