With 130,051 new cases and 29,963 deaths in 2020 endometrial carcinoma remains the most common gynaecological malignancy in Europe [1]. Moreover, incidence and mortality continue to rise due to the growing elderly population and increasing obesity prevalence among patients.

Although standard treatment of this cancer is total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) with or without adjuvant therapy, high BMI and multimorbidity can be contraindications for surgical intervention. It was estimated that 3–9% of patients are unable to undergo surgery because of medical comorbidities [[2], [3], [4]]. For this subset of women an alternative curative option is definitive radiotherapy including brachytherapy (BT) alone or combined with external beam radiotherapy (EBRT) [[4], [5], [6]]. In case of low risk tumors limited to uterus, with infiltration of less than one-half of the myometrium and no lymph node involvement, BT as monotherapy is preferable according to reduced toxicity due to ability to save organs-at-risk (OAR) accomplished by using conformal three dimensional (3D) image-guided techniques. Exclusive brachytherapy shortens the time spent in the hospital which seems important in this group of patients.

The aim of this prospective study was to evaluate outcomes of computed tomography (CT) image-guided (IG) high-dose-rate (HDR) intracavitary brachytherapy (ICBT) alone in patients with medically inoperable early-stage endometrial cancer. The early tolerance of the procedure and late side effects were also observed. Since only a small number of studies have been made on this particular topic, including several dozen patients on IG-ICBT, the presented data can contribute to furthering knowledge in this field.