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The EBRT total dose was 45\u00a0Gy. The interventional radiotherapy boost delivered 28\u00a0Gy in four high-dose-rate fractions, achieving 85\u201395\u00a0Gy EQD2 (\u03b1\/\u03b2 10) to the high-risk clinical target volume and 60\u00a0Gy EQD2 (\u03b1\/\u03b2 10) to the intermediate-risk clinical target volume. The primary endpoint was local control. Secondary endpoints included metastasis-free survival, overall survival, cancer-specific survival, and acute and late toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-two patients (median age, 54\u00a0years) were included. Two-year actuarial local control, metastasis-free survival, overall survival, and cancer-specific survival rates were 100%, 77.8%, 93%, and 93%, respectively. At univariate analysis, chemotherapy was significantly associated with a reduced risk of metastasis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0038). Among chemotherapy regimens, cisplatin-based therapy showed the lowest metastatic risk, with metastases occurring in 5% of patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Age\u2009&gt;\u200959\u00a0years was significantly associated with increased mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026). At multivariate analysis, age was the only independent predictor of mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Acute grade 2 gastrointestinal and skin toxicity occurred in two patients, while one patient experienced late grade 3 vaginal stenosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Image-guided interventional radiotherapy as a boost following EBRT for vaginal cuff recurrences is an effective and safe treatment option, providing excellent local control with a favourable toxicity profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11547-026-02235-8","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T09:14:20Z","timestamp":1781946860000},"page":"1362-1368","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Image-guided adaptive interventional radiotherapy (modern brachytherapy) boost for vaginal recurrences"],"prefix":"10.1007","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3507-7051","authenticated-orcid":false,"given":"Valentina","family":"Lancellotta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Concetta","family":"La Milia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Rosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Dragonetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Fionda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Bannoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Autorino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Nardangeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Tortoreto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Gui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Russo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeles","family":"Rovirosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio Giuseppe","family":"Morganti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Macchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonietta","family":"Gambacorta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Tagliaferri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"2235_CR1","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.ijrobp.2014.11.022","volume":"91","author":"CL Creutzberg","year":"2015","unstructured":"Creutzberg CL, van Stiphout RGPM, Nout RA et al (2015) Nomograms for prediction of outcome with or without adjuvant radiation therapy for patients with endometrial cancer: a pooled analysis of PORTEC-1 and PORTEC-2 trials. 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Luca Russo is an editor in this journal.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable. This study was performed within the framework of the Consortium for Brachytherapy Data Analysis initiative, following its standardized guidelines.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All patients signed the consent informed.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for publications","group":{"name":"EthicsHeading","label":"Declarations"}}]}}