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Abstract Background Despite evidence of the benefits of exercise in cancer survivors, exercise participation rates tend to decline after treatments. Few studies have examined the determinants of exercise in less common cancer sites. In this study, we examined medical, demographic, and social cognitive correlates of exercise in endometrial cancer survivors using the Theory of Planned Behavior (TPB). Methods A mailed survey was completed by 354 endometrial cancer survivors (1 to 10 years postdiagnosis) residing in Alberta, Canada. The study was cross-sectional. Exercise behavior was assessed using the Godin Leisure Time Exercise Questionnaire and the TPB constructs were assessed with standard self-report scales. Multiple regression analyses were used to determine the independent associations of the TPB constructs with intention and behavior. Results Chi-square analyses indicated that marital status (p = .003), income level (p = .013), and body mass index (BMI) (p = .020) were associated with exercise. The TPB explained 34.1% of the variance in exercise behavior with intention (β = .38, p < .001) and self-efficacy (β = .18, p = .029) being independent correlates. For intention, 38.3% of the variance was explained by the TPB with self-efficacy (β = .34, p < .001) and affective attitude (β = .30, p < .001) being the independent correlates. The TPB mediated the associations of marital status and BMI with exercise but not income level. Age and BMI moderated the associations of the TPB with intention and behavior. Conclusion The TPB may be a useful framework for understanding exercise in endometrial cancer survivors. Exercise behavior change interventions based on the TPB should be tested in this growing population.

To examine the efficacy of vaginal vault radiotherapy as adjuvant treatment for patients with high-grade, stage I/II endometrial adenocarcinoma who have been surgically staged.A retrospective chart review of 77 women between 1995 and 2006 with high-grade surgically staged I and II endometrial adenocarcinoma, who were treated with postoperative vaginal vault radiotherapy alone, was performed. The primary study end points were recurrence risk and sites of recurrence. The secondary end points were disease-free and overall survival. Kaplan-Meier estimates were calculated for overall and disease-free survival.Seventy-seven women were identified and met inclusion criteria. Sixty-seven (87%) had grade 3 histologic features on final pathologic report. Forty-two patients (55%) were classified as stage IB, having superficial myometrial invasion; 21 (27%) were stage IC, with deep invasion; and 6 (8%) were stage II, involving the cervix. The median follow-up was 80 months (6.6 years). There were 10 recurrences (13.0%), of which 3 were local: 1 involving the vaginal apex; 1, the lower vagina and pelvic sidewall; and 1, the lower vagina. The 5-year recurrence risk was 11.2% and the 5-year survival probability 88.9%.It seems that for this cohort of 77 patients with surgically staged I and II grade 3 endometrial adenocarcinoma, adjuvant vaginal vault radiotherapy alone leads to acceptable recurrence rates and survival while minimizing morbidity. [ABSTRACT FROM AUTHOR]

Altered fractionation radiotherapy features variations in frequency of radiotherapy delivery and/or amount of radiotherapy delivered at each treatment in an attempt to improve radiotherapy efficacy, depending on a given tumour's biologic nature. Several altered fractionation radiotherapy clinical trials for cervix cancer have been completed, but despite promising local control rates, these trials have been unsuccessful due to excessive radiotherapy toxicities. Radiotherapy in these trials was planned using traditional 4-field box techniques. Advanced radiotherapy planning and delivery systems such as helical tomotherapy offer the potential of planning and delivering altered fractionation regimens with improved critical structure avoidance. The purpose of this project is to perform a dosimetric comparison between tomotherapy and 4-field altered fractionation radiotherapy plans for cervix cancer cases. Two planning target volumes (PTV5) were defined for ten cervix cancer cases: PTV1 contained pelvic lymph nodes, gross tumour, uterus and parametria and PTV2 contained gross tumour, uterus and parametria. A tomotherapy and 4-field plan was created for each case. A dose of 45 Gy/25 fractions was prescribed to PTVI with a concomitant boost of 10 Gy to PTV2. Plans were normalized such that 95% of PTV2 received the prescribed dose. Plans were compared based on dose volume histogram criteria, target volume conformity indices and normal tissue complication and tumour control probability estimates. Tomotherapy plans had significantly better conformity indices for PTV2 coverage. Four-field plans had significantly higher minimum, median and mean PTV1 doses. Rectal, bladder and small bowel doses were significantly lower in tomotherapy plans. PTV2 tumour control probabilities were not significantly different between planning modalities. Bladder, rectal, and small bowel normal tissue complication estimates were significantly lower for tomotherapy plans. This data indicates tomotherapy plans confer superior boost volume coverage and critical structure avoidance compared with traditional 4-field plans for locally advanced cervical cancer. Direct clinical comparisons between tomotherapy and 4-field pelvic box radiotherapy plans for cervix cancer are needed to quantify tomotherapy's clinical benefits in terms of tumour control, radiotherapy toxicity rates and patient quality of life. [ABSTRACT FROM AUTHOR]