Twice-daily high-dose-rate brachytherapy for medically inoperable uterine cancer

Purpose Medically inoperable patients with uterine cancer pose a therapeutic challenge. We developed a twice-daily schedule of high-dose-rate brachytherapy (HDRB) after a single insertion procedure that required a hospitalization of 3 days. Methods and materials Favorable patients were offered brachytherapy alone, and all other patients received HDRB after pelvic external beam radiation therapy (EBRT). The prescribed dose was 7 Gy × 5 fractions and 4–5 Gy × 4–5 fractions for those treated after EBRT. HDRB was delivered with a b.i.d. schedule (4–6-h interval). Results Twenty-two patients (21 Stage I, 1 Stage IIB) were deemed medically inoperable. Sixteen patients received EBRT followed by HDRB, and six received HDRB alone. There were no procedural complications or significant acute toxicity. No thromboembolic events occurred within 30 days of the implant. Conclusions This technique allows patients to be treated using a single procedure for insertion, with brief hospitalization for twice-daily HDRB.