Short-course, higher dose vaginal brachytherapy for endometrial cancer shown to be effective

In a randomized clinical trial, researchers from Huntsman Cancer Institute at the University of Utah (the U) have found that short-course, higher dose vaginal brachytherapy for endometrial cancer had similar effectiveness to more frequent, lower dose sessions.

Gita Suneja, MD, MS, physician-scientist at Huntsman Cancer Institute and professor of radiation oncology at the U, is the first author of the SAVE trial report-which stands for, Short-Course Adjuvant Vaginal Cuff Brachytherapy in Early Endometrial Cancer Compared with Standard of Care.

There isn't high quality-data on optimal dose and schedule for brachytherapy treatments. Because of this, practice patterns really vary. The SAVE trial sought to try to lower the number of treatments that patients were receiving but maintain short-term quality of life and disease control."

Gita Suneja, MD, MS, physician-scientist at Huntsman Cancer Institute 

Endometrial cancer is a disease that begins in the lining of the uterus. The primary treatment for endometrial cancer is surgery, including the removal of the uterus, cervix, and upper vagina. Brachytherapy, a form of internal radiation, is used as a secondary treatment to prevent the cancer's return. Patients receiving vaginal cuff brachytherapy are treated with internal radiation by way of an applicator in the vaginal cavity.

The SAVE trial compared two groups who received different treatment doses over a varying number of sessions. The control group received the standard treatment-between three to five appointments with lower doses. The experimental group received higher doses of radiation in just two sessions.

The researchers found similarly effective short-term outcomes and few acute toxicities for the patients in the experimental group.

Suneja says the study outcomes will help improve cancer care for Huntsman Cancer Institute patients across the five states of the Mountain West.

"It's hard for patients to get to us, especially those in a rural and frontier environment like many of our patients at Huntsman Cancer Institute," says Suneja. "We recognize this is an enormous burden for people to come here for treatment, on top of dealing with a difficult diagnosis. We are motivated to better serve our rural population, and the results of this study will give us a way to do that."

David Gaffney, MD, PhD, FACR, FABS, FASTRO, physician-scientist at Huntsman Cancer Institute and professor of radiation oncology at the U, developed the idea for the SAVE study after seeing patient need. According to the American Cancer Society, endometrial cancer is the most common cancer of the female reproductive organs. Incidence is on the rise, as is the mortality rate.

"We are very grateful for the support and the enthusiasm from our clinical colleagues at MD Anderson, Loyola, Intermountain Healthcare, and Stanford, the institutions that also participated in the SAVE trial," says Gaffney. "We are particularly grateful for the patients that agreed to participate in the study. It is a big win when we can preserve good outcomes and make cancer care easier."

The results of the SAVE trial were published in JCO Oncology Advances.

The National Clinical Trial number for this trial is 03422198.