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Adjuvant radiotherapy in Stage II endometrial carcinoma: Is brachytherapy alone sufficient for local control?
- Source :
- Brachytherapy. 14(4)
- Publication Year :
- 2014
-
Abstract
- OBJECTIVE: To evaluate recurrence patterns and overall survival in patients treated with adju- vant 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 41 months. RESULTS: Median patient age was 59 years (range, 42e87 years). All tumors were of endome- trioid 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 5 0.510) or freedom from vaginal (p 5 0.840), distant (p 5 0.133), or any recurrence (p 5 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 re- currences. 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 endome- trial 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. 2015 American Brachy
- Subjects :
- Adult
medicine.medical_specialty
medicine.medical_treatment
Brachytherapy
Kaplan-Meier Estimate
Adenocarcinoma
Hysterectomy
Risk Factors
Carcinoma
Medicine
Humans
Radiology, Nuclear Medicine and imaging
External beam radiotherapy
Lymph node
Aged
Neoplasm Staging
Retrospective Studies
Aged, 80 and over
Univariate analysis
business.industry
Endometrial cancer
Cancer
Middle Aged
medicine.disease
Surgery
Endometrial Neoplasms
Dissection
medicine.anatomical_structure
Oncology
Female
Radiotherapy, Adjuvant
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 18731449
- Volume :
- 14
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Brachytherapy
- Accession number :
- edsair.doi.dedup.....866770b01628fe2e0ab5d6afe5dc309e