Postoperative radiotherapy for endometrial cancer

Abstract

PurposeTo investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma.Materials and MethodsSixty four patients with stage I-III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended field. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months.ResultsFive year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications.ConclusionStage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.

A multicenter analysis of adjuvant therapy after surgery for stage IIIC endometrial adenocarcinoma: A Korean Radiation Oncology Group study (KROG 13-17)

“…One hundred nine patients were treated with concurrent CTRT (86.5%), 10 patients with CT followed by RT (7.9%), and 7 patients with RT followed by CT (5.6%). Adjuvant CT was delivered with a median of 6 cycles (range, [3][4][5][6][7][8][9][10][11][12], although 3 patients received only 2 cycles. Six patients did not complete the full course of CT because of G4 hematologic toxicity (n = 2), intravascular hemolysis (n = 1), or no available data on toxicity (n = 3).…”

“…Traditionally, postoperative radiotherapy (RT) has been employed in stage IIIC endometrial carcinoma to improve locoregional control and outcome [1][2][3]. Recently, with advances in chemotherapy (CT), the majority of adjuvant treatment consists of CT with or without RT in high-risk or advanced stage endometrial cancer; in randomized settings, some investigators are trying CT intensification instead of RT [4][5][6].…”

Adjuvant Treatment after Surgery in Stage IIIA Endometrial Adenocarcinoma

“…The optimal adjuvant management for patients with advanced endometrial cancer has yet to be defined, particularly for IIIA patients as incidence is low, representing only 2.6% of patients with endometrial cancer [ 7 ]. Radiotherapy (RT) has traditionally been employed in advanced endometrial carcinoma to improve locoregional control [ 8 , 9 ]. Several studies have evaluated the role of combined modality adjuvant therapy compared with a single modality in advanced endometrial cancer and have suggested that combined chemoradiotherapy (CTRT) can provide additional benefits compared with computed tomography (CT) or RT alone [ 10 - 13 ].…”