{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:15:35Z","timestamp":1780528535034,"version":"3.54.1"},"reference-count":43,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["practicalradonc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Practical Radiation Oncology"],"published-print":{"date-parts":[[2023,9]]},"DOI":"10.1016\/j.prro.2023.05.009","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T23:04:19Z","timestamp":1686179059000},"page":"e416-e422","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Partial-Length Treatment With Brachytherapy in Patients With Endometrial Cancer With High-Risk Features Is as Effective as Full-Length Vaginal Brachytherapy but With Reduced Toxicity"],"prefix":"10.1016","volume":"13","author":[{"given":"A.Gabriella","family":"Wernicke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhupesh","family":"Parashar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen","family":"Samuel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Sabbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Caputo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.prro.2023.05.009_bib0001","unstructured":"National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology, uterine neoplasms (V2.2015). Available at: http:\/\/www.nccn.org\/professionals\/physician_gls\/PDF\/uterine.pdf. Accessed June 21, 2015."},{"key":"10.1016\/j.prro.2023.05.009_bib0002","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.ygyno.2009.03.003","article-title":"Current and emerging trends in Lynch syndrome identification in women with endometrial cancer","volume":"114","author":"Resnick","year":"2009","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0003","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1200\/JCO.2004.08.159","article-title":"Outcome of high-risk stage IC, grade 3, compared with stage I endometrial carcinoma patients: The Postoperative Radiation Therapy in Endometrial Carcinoma Trial","volume":"22","author":"Creutzberg","year":"2004","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0004","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1016\/j.ijrobp.2011.03.054","article-title":"The influence of radiation modality and lymph node dissection on survival in early-stage endometrial cancer","volume":"82","author":"Chino","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0005","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1001\/jama.295.4.389","article-title":"Frequency and effect of adjuvant radiation therapy among women with stage I endometrial adenocarcinoma","volume":"295","author":"Lee","year":"2006","journal-title":"JAMA"},{"key":"10.1016\/j.prro.2023.05.009_bib0006","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1200\/JCO.2004.00.7617","article-title":"Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: A Gynecologic Oncology Group study","volume":"24","author":"Randall","year":"2006","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0007","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1097\/IGC.0b013e31822e7588","article-title":"Role of adjuvant chemotherapy in patients with early stage uterine papillary serous cancer","volume":"21","author":"Mahdavi","year":"2011","journal-title":"Int J Gynecol Cancer"},{"key":"10.1016\/j.prro.2023.05.009_bib0008","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/IGC.0b013e3182094ded","article-title":"The role of adjuvant chemotherapy in surgical stages I-II serous and clear cell carcinomas and carcinosarcoma of the endometrium: A collaborative study","volume":"21","author":"Vandenput","year":"2011","journal-title":"Int J Gynecol Cancer"},{"key":"10.1016\/j.prro.2023.05.009_bib0009","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2013.12.025","article-title":"Secondary analyses from a randomized clinical trial: Age as the key prognostic factor in endometrial carcinoma","volume":"210","author":"Benedetti Panici","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.prro.2023.05.009_bib0010","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ygyno.2013.10.023","article-title":"High-grade endometrial cancer: Revisiting the impact of tumor size and location on outcomes","volume":"132","author":"Doll","year":"2014","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0011","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/S1470-2045(19)30395-X","article-title":"Adjuvant chemoradiotherapy versus radiotherapy alone in women with high-risk endometrial cancer (PORTEC-3: Patterns of recurrence and post-hoc survival analysis of a randomised phase 3 trial","volume":"20","author":"De Boer","year":"2019","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0012","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1056\/NEJMoa1813181","article-title":"Adjuvant chemotherapy plus radiation for locally advanced endometrial cancer","volume":"380","author":"Matei","year":"2019","journal-title":"N Engl J Med"},{"key":"10.1016\/j.prro.2023.05.009_bib0013","first-page":"419","article-title":"Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: Clinical and histopathologic study of 540 patients","volume":"56","author":"Aalders","year":"1980","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.prro.2023.05.009_bib0014","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S0140-6736(08)61767-5","article-title":"Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): Pooled trial results, systematic review, and meta-analysis","volume":"373","author":"Blake","year":"2009","journal-title":"Lancet"},{"key":"10.1016\/j.prro.2023.05.009_bib0015","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/S0140-6736(00)02139-5","article-title":"Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: Multicenter randomised trial. PORTEC Study Group. Post Operative Radiation Therapy in Endometrial Carcinoma","volume":"355","author":"Creutzberg","year":"2000","journal-title":"Lancet"},{"key":"10.1016\/j.prro.2023.05.009_bib0016","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.ygyno.2003.11.048","article-title":"A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: A Gynecologic Oncology Group study","volume":"92","author":"Keys","year":"2004","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0017","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/S0140-6736(09)62163-2","article-title":"Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): An open-label, non-inferiority, randomised trial","volume":"375","author":"Nout","year":"2010","journal-title":"Lancet"},{"key":"10.1016\/j.prro.2023.05.009_bib0018","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.brachy.2015.09.012","article-title":"Vaginal brachytherapy for postoperative endometrial cancer: 2014 Survey of the American Brachytherapy Society","volume":"15","author":"Harkenrider","year":"2016","journal-title":"Brachytherapy"},{"key":"10.1016\/j.prro.2023.05.009_bib0019","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/0360-3016(90)90094-Z","article-title":"Postoperative vaginal irradiation with high dose rate afterloading technique in endometrial carcinoma stage I","volume":"18","author":"Sorbe","year":"1990","journal-title":"Int J Radiat Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0020","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.brachy.2019.08.007","article-title":"The vaginal cylinder: Misunderstood, misused, or trivial? An in-depth dosimetric and multiinstitutional outcome investigation","volume":"18","author":"Guy","year":"2019","journal-title":"Brachytherapy"},{"key":"10.1016\/j.prro.2023.05.009_bib0021","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.ijrobp.2010.10.071","article-title":"Determination of prognostic factors for vaginal mucosal toxicity associated with intravaginal high-dose rate brachytherapy in patients with endometrial cancer","volume":"82","author":"Bahng","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0022","doi-asserted-by":"crossref","first-page":"40","DOI":"10.5114\/jcb.2018.74140","article-title":"Late G2 vagina toxicity in post-operative endometrial carcinoma is associated with a 68 Gy dose equivalent to 2 Gy per fraction ((\u03b1\/\u03b2=3Gy)) at 2 cm(3) of vagina","volume":"10","author":"Aguilera","year":"2018","journal-title":"J Contemp Brachytherapy"},{"key":"10.1016\/j.prro.2023.05.009_bib0023","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/BF03039188","article-title":"The vaginal stump recurrence rate in endometrial carcinoma in relation to the target volume of postoperative HDR-afterloading brachytherapy","volume":"173","author":"Kloetzer","year":"1997","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.prro.2023.05.009_bib0024","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.rpor.2020.01.002","article-title":"Postoperative endometrial carcinoma treated with external beam irradiation plus vaginal-cuff brachytherapy. Is there a dose relationship with G2 vaginal complications?","volume":"25","author":"Zhang","year":"2020","journal-title":"Rep Pract Oncol Radiother"},{"key":"10.1016\/j.prro.2023.05.009_bib0025","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.brachy.2011.08.005","article-title":"American Brachytherapy Society consensus guidelines for adjuvant vaginal cuff brachytherapy after hysterectomy","volume":"11","author":"Small","year":"2012","journal-title":"Brachytherapy"},{"key":"10.1016\/j.prro.2023.05.009_bib0026","doi-asserted-by":"crossref","first-page":"e631","DOI":"10.1016\/j.ijrobp.2011.04.013","article-title":"Fifteen-year radiotherapy outcomes of the randomized PORTEC-1 trial for endometrial carcinoma","volume":"81","author":"Creutzberg","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0027","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/1748-717X-9-141","article-title":"Survival of women with clear cell and papillary serous endometrial cancer after adjuvant radiotherapy","volume":"9","author":"Foerster","year":"2014","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0028","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.ygyno.2014.02.032","article-title":"Adjuvant radiation in early stage, unfavorable histology endometrial carcinoma is associated with improved local control and survival","volume":"133","author":"Ly","year":"2014","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0029","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ygyno.2018.07.020","article-title":"Molecular-integrated risk profile to determine adjuvant radiotherapy in endometrial cancer: Evaluation of the pilot phase of the PORTEC-4a trial","volume":"151","author":"Wortman","year":"2018","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0030","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1200\/JCO.18.01575","article-title":"Phase III trial: Adjuvant pelvic radiation therapy versus vaginal brachytherapy plus paclitaxel\/carboplatin in high-intermediate and high-risk early-stage endometrial cancer","volume":"37","author":"Randall","year":"2019","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0031","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1200\/JCO.2010.32.4590","article-title":"Long-term outcome and quality of life of patients with endometrial carcinoma treated with or without pelvic radiotherapy in the post operative radiation therapy in endometrial carcinoma 1 (PORTEC-1) trial","volume":"29","author":"Nout","year":"2011","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0032","doi-asserted-by":"crossref","first-page":"3951","DOI":"10.1200\/JCO.2013.48.8023","article-title":"Long-term outcomes after pelvic radiation for early-stage endometrial cancer","volume":"31","author":"Onsrud","year":"2013","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0033","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.ygyno.2009.06.027","article-title":"Adjuvant vaginal brachytherapy alone for high risk localized endometrial cancer as defined by the three major randomized trials of adjuvant pelvic radiation","volume":"116","author":"McCloskey","year":"2010","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0034","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.ejon.2004.03.009","article-title":"Patients\u2019 experiences of intracavity brachytherapy treatment for gynaecological cancer","volume":"9","author":"Warnock","year":"2005","journal-title":"Eur J Oncol Nurs"},{"key":"10.1016\/j.prro.2023.05.009_bib0035","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.prro.2012.12.002","article-title":"Comparing rates of urinary tract infections among patients receiving adjuvant pelvic intensity modulated radiotherapy, 3-dimentional conformal radiation therapy and brachytherapy","volume":"3","author":"Boothe","year":"2013","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.prro.2023.05.009_bib0036","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.brachy.2015.03.001","article-title":"Predictors of vaginal stenosis after intravaginal high-dose-rate brachytherapy for endometrial carcinoma","volume":"14","author":"Park","year":"2015","journal-title":"Brachytherapy"},{"key":"10.1016\/j.prro.2023.05.009_bib0037","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD007291.pub2","article-title":"Vaginal dilator therapy for women receiving pelvic radiotherapy","author":"Miles","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.prro.2023.05.009_bib0038","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/0360-3016(80)90227-8","article-title":"Radiation tolerance of the vaginal mucosa","volume":"6","author":"Hintz","year":"1980","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0039","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1016\/j.ijrobp.2005.04.038","article-title":"American Brachytherapy Society survey regarding practice patterns of postoperative irradiation for endometrial cancer: Current status of vaginal brachytherapy","volume":"63","author":"Small","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0040","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/0360-3016(94)90357-3","article-title":"Postoperative high dose-rate intravaginal brachytherapy combined with external irradiation for early stage endometrial cancer: A long-term follow-up","volume":"30","author":"Nori","year":"1994","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0041","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/0360-3016(87)90062-9","article-title":"Combined surgery and radiation in endometrial carcinoma: An analysis of prognostic factors","volume":"13","author":"Nori","year":"1987","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0042","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/0360-3016(85)90177-4","article-title":"Postoperative vaginal radiation in endometrial cancer using a remote afterloading technique","volume":"11","author":"Mandell","year":"1985","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.prro.2023.05.009_bib0043","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.prro.2022.09.002","article-title":"Radiation therapy for endometrial cancer: An American Society for Radiation Oncology Clinical Practice Guideline","volume":"13","author":"Harkenrider","year":"2023","journal-title":"Pract Radiation Oncol"}],"container-title":["Practical Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1879850023001649?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1879850023001649?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T10:25:12Z","timestamp":1761819912000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1879850023001649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":43,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S1879850023001649"],"URL":"https:\/\/doi.org\/10.1016\/j.prro.2023.05.009","relation":{},"ISSN":["1879-8500"],"issn-type":[{"value":"1879-8500","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Partial-Length Treatment With Brachytherapy in Patients With Endometrial Cancer With High-Risk Features Is as Effective as Full-Length Vaginal Brachytherapy but With Reduced Toxicity","name":"articletitle","label":"Article Title"},{"value":"Practical Radiation Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.prro.2023.05.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}