Vaginal cuff brachytherapy is an essential component of adjuvant post-operative therapy in endometrial carcinoma. Brachytherapy boost, as a part of adjuvant pelvic radiotherapy, including concomitant chemoradiotherapy combined with four cycles carboplatin/paclitaxel chemotherapy, is used in early-stage high-risk and advanced stage disease. This strategy is widely accepted and recommended by international guidelines, despite the fact that combined therapy has never been verified in randomized trials. Brachytherapy alone is the adjuvant treatment of choice for many patients with early-stage endometrial cancer, with high-intermediate features, replacing external beam pelvic radiotherapy. It provides equivalent vaginal control with a lower risk of toxicity, and minimal impact on health-related quality of life. Available evidence did not demonstrate the superiority of sole vaginal brachytherapy combined with three cycles of carboplatin/paclitaxel chemotherapy, over the standard pelvic irradiation for patients with early-stage, high-intermediate-, and high-risk endometrial cancer. This article summarized the available evidence on the role of post-operative vaginal cuff brachytherapy in endometrial cancer patients. Additionally, the risk groups definition, some aspects of brachytherapy technique, and the importance of pathological and molecular risk factors for endometrial cancer risk stratification were presented. Furthermore, the role of brachytherapy according to the European Society of Gynecological Oncology/European Society for Radiotherapy and Oncology/European Society of Pathology 2021 guidelines for the management of patients with endometrial carcinoma was presented.

中文翻译：

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鉴于最近的证据，对接受手术治疗的子宫内膜癌患者进行辅助性阴道袖套近距离放射治疗

阴道袖带近距离放射治疗是子宫内膜癌术后辅助治疗的重要组成部分。作为辅助盆腔放疗的一部分，近距离放疗增强疗法包括伴随放化疗和四周期卡铂/紫杉醇化疗的组合，被用于早期高危和晚期疾病。尽管联合疗法从未在随机试验中得到证实，但这一策略已被国际准则广泛接受并推荐。对于许多患有早期子宫内膜癌且具有高中度特征的患者，仅近距离放射疗法是首选的辅助治疗，替代了体外束骨盆放疗。它提供与阴道同等的控制权，具有较低的毒性风险，并且对与健康相关的生活质量的影响最小。对于早期，高中，高危子宫内膜癌患者，现有的证据并未证明单独的阴道近距离放射疗法与三周期卡铂/紫杉醇化疗相结合优于标准盆腔放疗。本文总结了有关子宫内膜癌患者术后阴道袖套近距离放射治疗作用的现有证据。此外，还介绍了危险人群的定义，近距离放射治疗技术的某些方面以及病理和分子危险因素对子宫内膜癌危险分层的重要性。此外，