Vaginal Brachytherapy Recommendations for Endometrial Cancer

Target Length and Location

• The National Comprehensive Cancer Network recommends that the target for vaginal brachytherapy after hysterectomy should be limited to the upper vagina only 1, 2, 3

Dose Recommendations

For High-Dose Rate (HDR) Vaginal Brachytherapy Alone:

• The National Comprehensive Cancer Network recommends 7 Gy × 3 fractions prescribed at a depth of 0.5 cm from the vaginal surface 1, 2, 3
• The National Comprehensive Cancer Network recommends 6 Gy × 5 fractions prescribed directly to the vaginal surface 1, 2, 3

For HDR Vaginal Brachytherapy as a Boost After External Beam Radiation Therapy (EBRT):

• The National Comprehensive Cancer Network recommends 4-6 Gy × 2-3 fractions prescribed to the vaginal mucosa 1, 3
• The National Comprehensive Cancer Network recommends 5-6 Gy × 2 fractions to the vaginal mucosa 4, 5

Technical Considerations

• The National Comprehensive Cancer Network recommends that the dose should be prescribed to either the vaginal surface or at a depth of 0.5 cm from the vaginal surface, depending on the chosen regimen 1, 2, 3

Clinical Considerations

• Patients treated with vaginal brachytherapy are prone to vaginal stenosis, which can impair sexual function; vaginal dilators can be used starting 2-4 weeks after treatment completion 4