TY - JOUR
T1 - Adjuvant radiotherapy in Stage II endometrial carcinoma
T2 - Is brachytherapy alone sufficient for local control?
AU - Paydar, Ima
AU - DeWees, Todd
AU - Powell, Matthew
AU - Mutch, David G.
AU - Grigsby, Perry W.
AU - Schwarz, Julie K.
N1 - Publisher Copyright:
© 2015 American Brachytherapy Society.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Objective: To evaluate recurrence patterns and overall survival in patients treated with adjuvant radiation after surgical staging for Stage II endometrial carcinoma. Secondary goals include identification of prognostic factors for recurrence and toxicity assessment. Methods/Materials: The medical records of 41 patients treated with adjuvant radiotherapy at Washington University School of Medicine after surgical staging for endometrial cancer (total abdominal hysterectomy and bilateral salpingo-oophorectomy, peritoneal cytology, lymph node dissection) were reviewed. Nineteen were treated with a combination of external beam radiotherapy and vaginal brachytherapy (VB), and 22 patients were treated with postoperative VB alone. Median followup for all patients was 41months. Results: Median patient age was 59years (range, 42-87years). All tumors were of endometrioid histology. There were 20 Grade 1 tumors, 13 Grade 2 tumors, and 8 Grade 3 tumors. For all patients, the 5-year overall survival was 69.8%, and the 5-year recurrence-free survival was 89.0%. There was no statistically significant difference in overall survival (p= 0.510) or freedom from vaginal (p= 0.840), distant (p= 0.133), or any recurrence (p= 0.275) with respect to modality of treatment (external beam radiotherapy and VB vs. VB alone). There were no pelvic lymph node recurrences. In the univariate analysis, there were no risk factors influencing overall survival or recurrences. One patient experienced a toxicity requiring hospital admission. She was treated with pelvic external beam radiation plus brachytherapy. Conclusions: VB alone results in excellent local control for patients with Stage II endometrial cancer after surgical staging. Long-term toxicities are rare and more common in the group of patients who were treated with pelvic external beam plus brachytherapy.
AB - Objective: To evaluate recurrence patterns and overall survival in patients treated with adjuvant radiation after surgical staging for Stage II endometrial carcinoma. Secondary goals include identification of prognostic factors for recurrence and toxicity assessment. Methods/Materials: The medical records of 41 patients treated with adjuvant radiotherapy at Washington University School of Medicine after surgical staging for endometrial cancer (total abdominal hysterectomy and bilateral salpingo-oophorectomy, peritoneal cytology, lymph node dissection) were reviewed. Nineteen were treated with a combination of external beam radiotherapy and vaginal brachytherapy (VB), and 22 patients were treated with postoperative VB alone. Median followup for all patients was 41months. Results: Median patient age was 59years (range, 42-87years). All tumors were of endometrioid histology. There were 20 Grade 1 tumors, 13 Grade 2 tumors, and 8 Grade 3 tumors. For all patients, the 5-year overall survival was 69.8%, and the 5-year recurrence-free survival was 89.0%. There was no statistically significant difference in overall survival (p= 0.510) or freedom from vaginal (p= 0.840), distant (p= 0.133), or any recurrence (p= 0.275) with respect to modality of treatment (external beam radiotherapy and VB vs. VB alone). There were no pelvic lymph node recurrences. In the univariate analysis, there were no risk factors influencing overall survival or recurrences. One patient experienced a toxicity requiring hospital admission. She was treated with pelvic external beam radiation plus brachytherapy. Conclusions: VB alone results in excellent local control for patients with Stage II endometrial cancer after surgical staging. Long-term toxicities are rare and more common in the group of patients who were treated with pelvic external beam plus brachytherapy.
KW - Adjuvant radiation
KW - Endometrial adenocarcinoma
KW - Gynecologic malignancy
UR - http://www.scopus.com/inward/record.url?scp=84930752646&partnerID=8YFLogxK
U2 - 10.1016/j.brachy.2015.02.196
DO - 10.1016/j.brachy.2015.02.196
M3 - Article
C2 - 25911995
AN - SCOPUS:84930752646
SN - 1538-4721
VL - 14
SP - 427
EP - 432
JO - Brachytherapy
JF - Brachytherapy
IS - 4
ER -