Does the length of vagina treated with adjuvant HDR brachytherapy affect toxicity and recurrence outcomes for patients with high risk endometrial cancer? Practice is varied in this population and the ABS guidelines recommend considering full length treatment for high risk features. In this retrospective study of 240 patients with high risk endometrial cancer were treated with vaginal BT to a dose of 21 Gy in 3 fractions. Half (50.4%) received treatment to the full length of the vagina (cuff to introitus) and half received treatment to the upper third vagina. The rate of vaginal recurrence was low and similar with partial versus full length treatment (0.9% v 1.4%), and no patients had a distal vaginal recurrence. Toxicity was much higher with full length treatment as all of those patients had grade 3 vaginal mucositis compared to none of the partial group, and 23% of the full length group had grade 3 stenosis compared to none of the partial group. | Wernicke, Pract Radiat Oncol 2023
