Julie K Schwarz1, Sushil Beriwal2, Jacqueline Esthappan3, Beth Erickson4, Colleen Feltmate5, Anthony Fyles6, David Gaffney7, Ellen Jones8, Ann Klopp9, William Small10, Bruce Thomadsen11, Catheryn Yashar12, Akila Viswanathan13. 1. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO. Electronic address: jschwarz@radonc.wustl.edu. 2. Department of Radiation Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA. 3. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO. 4. Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI. 5. Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA. 6. Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada. 7. Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT. 8. Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC. 9. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX. 10. Department of Radiation Oncology, Loyola University, Chicago, IL. 11. Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI. 12. Department of Radiation Medicine and Applied Sciences, University of California San Diego Moores Cancer Center, San Diego, CA. 13. Department of Radiation Oncology, Harvard Medical School, Boston, MA.
Abstract
PURPOSE: The purpose of this consensus statement from the American Brachytherapy Society (ABS) is to summarize recent advances and to generate general guidelines for the management of medically inoperable endometrial cancer patients with radiation therapy. METHODS: Recent advances in the literature were summarized and reviewed by a panel of experts. Panel members participated in a series of conference calls and were surveyed to determine their current practices and patterns. This document was reviewed and approved by the full panel, the ABS Board of Directors and the ACR Commission on Radiation Oncology. RESULTS: A transition from two-dimensional (2D) to three-dimensional (3D) treatment planning for the definitive treatment of medically inoperable endometrial cancer is described. Magnetic resonance (MR) imaging can be used to define the gross tumor volume (GTV), clinical target volume (CTV), and the organs at risk (OARs). Brachytherapy alone can be used for medically inoperable endometrial cancer patients with clinical Stage I cancer with no lymph node involvement and no evidence of deep invasion of the myometrium on MR imaging. In the absence of MR imaging, a combined approach using external beam and brachytherapy may be considered. CONCLUSIONS: Recent advances support the use of MR imaging and 3D planning for brachytherapy treatment for medically inoperable endometrial cancer.
PURPOSE: The purpose of this consensus statement from the American Brachytherapy Society (ABS) is to summarize recent advances and to generate general guidelines for the management of medically inoperable endometrial cancerpatients with radiation therapy. METHODS: Recent advances in the literature were summarized and reviewed by a panel of experts. Panel members participated in a series of conference calls and were surveyed to determine their current practices and patterns. This document was reviewed and approved by the full panel, the ABS Board of Directors and the ACR Commission on Radiation Oncology. RESULTS: A transition from two-dimensional (2D) to three-dimensional (3D) treatment planning for the definitive treatment of medically inoperable endometrial cancer is described. Magnetic resonance (MR) imaging can be used to define the gross tumor volume (GTV), clinical target volume (CTV), and the organs at risk (OARs). Brachytherapy alone can be used for medically inoperable endometrial cancerpatients with clinical Stage I cancer with no lymph node involvement and no evidence of deep invasion of the myometrium on MR imaging. In the absence of MR imaging, a combined approach using external beam and brachytherapy may be considered. CONCLUSIONS: Recent advances support the use of MR imaging and 3D planning for brachytherapy treatment for medically inoperable endometrial cancer.
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