Brachy-ing Unresectable Endometrial Cancers with Magnetic Resonance Guidance

The standard treatment for endometrial cancer is upfront surgery. However, surgical resection is challenging in locally advanced cases extending to the vagina, bladder, bowel, rectum, or parametria. Historically, these cases were managed palliatively due to the inability to escalate radiation dose safely and accurately, and there is a paucity of literature supporting definitive radiation for these patients. Technological advances in brachytherapy, including magnetic resonance guidance (MR-guidance) and interstitial techniques, have improved target precision and dose escalation without additional toxicity to permit curative management. We report two cases of unresectable, locally advanced endometrial cancers treated with MR-guided radiation.