A groundbreaking clinical trial has validated a more efficient approach to vaginal brachytherapy for endometrial cancer patients, potentially transforming standard treatment protocols. The SAVE trial (Short-Course Adjuvant Vaginal Cuff Brachytherapy in Early Endometrial Cancer Compared with Standard of Care), conducted by researchers at Huntsman Cancer Institute at the University of Utah, demonstrates that higher-dose radiation delivered in just two sessions achieves comparable effectiveness to conventional multiple-session treatments.
"There isn't high quality-data on optimal dose and schedule for brachytherapy treatments. Because of this, practice patterns really vary," explains Dr. Gita Suneja, the trial's lead author and physician-scientist at Huntsman Cancer Institute. "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."
Study Design and Findings
The clinical trial compared two distinct treatment approaches. While the control group received standard treatment consisting of three to five appointments with lower radiation doses, the experimental group underwent just two sessions with higher doses. The research team observed similar short-term outcomes and minimal acute toxicities in both groups, validating the shorter treatment protocol's efficacy.
Endometrial cancer, which originates in the uterine lining, typically requires surgical intervention as the primary treatment, including removal of the uterus, cervix, and upper vagina. Brachytherapy serves as a secondary treatment to prevent cancer recurrence, involving the placement of an internal radiation applicator in the vaginal cavity.
Impact on Patient Care
The study's findings hold particular significance for patients in rural and frontier environments. Dr. Suneja emphasizes the practical benefits: "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. We recognize this is an enormous burden for people to come here for treatment, on top of dealing with a difficult diagnosis."
The research addresses a growing healthcare concern, as endometrial cancer remains the most common cancer affecting female reproductive organs, with both incidence and mortality rates showing an upward trend, according to the American Cancer Society.
Multi-Center Collaboration
Dr. David Gaffney, who conceived the SAVE study idea based on observed patient needs, acknowledges the collaborative effort behind the research. "We are very grateful for the support and the enthusiasm from our clinical colleagues at MD Anderson, Loyola, Intermountain Healthcare, and Stanford," says Gaffney. "It is a big win when we can preserve good outcomes and make cancer care easier."
The findings, published in JCO Oncology Advances, represent a significant step forward in optimizing cancer care delivery while maintaining treatment efficacy. This development could particularly benefit patients facing geographical or logistical barriers to accessing multiple treatment sessions.
