Prevention of vaginal recurrence of stage I endometrial adenocarcinoma with postoperative vaginal radiation

Marchetti, David L.; Piver,; Tsukada, Yoshiaki; Reese, Peter A.

doi:10.1016/0020-7292(87)90306-7

Cited by 9 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alternatively, highactivity sources have been used to deliver equivalent doses to the vaginal apex with high dose rate treatment divided into several fractions. Postoperative vaginal cuff irradiation appears to prevent most vaginal apex recurrences [33][34][35] and because the dose of radiation decreases sharply at distances of more than a few millimeters from the vaginal surface, the risk of damage to adjacent structures is very low when appropriate doses and dose rates or fractionation schemes are used.…”

Section: Vaginal Cuff Treatmentmentioning

confidence: 99%

Intracavitary brachytherapy in the treatment of gynecologic neoplasms

Eifel

1997

J. Surg. Oncol.

View full text Add to dashboard Cite

Modern intracavitary brachytherapy carefully combined with megavoltage external beam radiotherapy is responsible for the high cure rates achieved with radiation treatment of invasive cervical cancers. Pelvic disease recurrence is rare after treatment of patients with tumors <5 cm in diameter, and even patients with massive tumors 8–10 cm in diameter are cured in 30–50% of cases. Inoperable adenocarcinomas of the endometrium and superficial cancers of the vagina are also effectively treated with intracavitary irradiation. The relative radioresistance of the uterus and vagina, physical advantages resulting from exploitation of the inverse square law, and the radiobiological advantages of low dose rate radiation have combined to make intracavitary irradiation a critical tool in the management of many gynecologic neoplasms. J. Surg. Oncol. 1997;66:141–147. © 1997 Wiley‐Liss, Inc.

show abstract

Section: Vaginal Cuff Treatmentmentioning

confidence: 99%

Intracavitary brachytherapy in the treatment of gynecologic neoplasms

Eifel

1997

J. Surg. Oncol.

View full text Add to dashboard Cite

show abstract

“…Substantial data suggests that the preferred option is postoperative intracavity irradiation of the whole vagina (1' 2' 6"18' 19' 24"25' 33"35' ss) . An increasing number of authorities believe external pelvic irradiation with or without the vaginal irradiation is also indicated in poorly differentiated, deeply invasive stage I and most stage II tumors (1,2,25,33,35,39,(44)(45)(46).…”

mentioning

confidence: 99%

The efficacy of postoperative vaginal irradiation in preventing vaginal recurrence in endometrial cancer

Elliott

Green

Coates

et al. 1994

Int J Gynecol Cancer

View full text Add to dashboard Cite

Between 1960 and 1985 hysterectomy was performed on 811 FIGO stage I and 116 stage II endometrial cancers which were divided into three groups: low-risk stage Ii (grade 1 and 2 lesions confined to the inner third of the myometrium; high-risk stage Iii (grade 3 and/or invading to the middle third of the myometrium or beyond); and FIGO stage II tumors (also high-risk). Hysterectomy was the only treatment in 492; in 145 the vaginal vault alone was radiated and in 290 the whole vagina, in each instance by an intracavity dose of 60Gy; in 34 of the latter high-risk tumors the pelvis received an additional 46Gy by external beam therapy. Forty isolated vaginal recurrences were detected; 10 in 308 low-risk and 22 in 184 high-risk tumors treated by surgery alone, and two and five in 40 low and 105 high-risk patients, respectively, who received adjuvant vault irradiation. No recurrences followed irradiation of the whole vaginal mucosa in 163 stage Ii low-risk and 40 stage II lesions and one, 9 years later, in 87 high-risk stage Iii tumors. Nearly 45% of patients with vaginal recurrence died from cancer within 1 year, 77% within 5 years and only 10% survived their recurrence 10 years. Total vaginal irradiation eliminated vaginal recurrences in low risk and reduced the incidence to 2.1% at 20 years after high-risk tumors.

show abstract

“…Lymphadenectomy was not routinely performed in this low‐risk population, a practice which is consistent with the American College of Obstetrics and Gynecology Technical Bulletin on endometrial cancer ( 18 ) . Furthermore, lymphadenectomy also was not performed in the previously reported Roswell Park series ( 6 , 14 ) . In the absence of lymphadenectomy, a recommendation for whole pelvic radiation could be made despite its increased morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Marchetti et al. utilized vaginal cuff radiation in 68 patients with grade 1 and 2 tumors with less than 50% myometrial invasion and followed them for a median of 4.8 years without evidence of local recurrence ( 6 ) . This series was recently updated with a total of 332 patients without evidence of local recurrent disease ( 14 ) .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Brachytherapy for early endometrial carcinoma: a comparative study with long-term follow-up

Rose¹,

Tak²,

Fitzgerald³

et al. 1999

Int J Gynecol Cancer

View full text Add to dashboard Cite

The current study was undertaken to evaluate the effect of preoperative uterine or postoperative vaginal brachytherapy compared to no adjuvant therapy on the disease-free interval, sites of recurrence, and survival in favorable stage IB endometrial carcinoma. One hundred and forty-six patients with FIGO grade 1 and 2 endometrial carcinoma and 1-33% myometrial invasion treated between 1974 and 1992 were retrospectively studied. The use of brachytherapy varied among the treating physicians during the study period. A Kaplan-Meier survival analysis was used to estimate disease-free survival and differences between treatment groups were evaluated with the Mantel-Cox statistic. Recurrent disease occurred in 7 patients (5.3%). Vaginal recurrences accounted for 6 of the 7 sites of recurrences. Recurrences occurred in 1.3% of grade 1 vs. 8.7% of grade 2 tumors (P = 0.04). Among 69 grade 2 tumors, recurrences occurred in 7.5% of those treated with brachytherapy vs. 10.3% of those not treated (P = 0.68). Brachytherapy did not affect the disease-free or overall survival. No serious complications directly related to therapy occurred. Vaginal recurrences occur even in early endometrial carcinoma. This study demonstrates no apparent benefit to brachytherapy. A larger study would be required to see a recurrence or survival difference.

show abstract

Prevention of vaginal recurrence of stage I endometrial adenocarcinoma with postoperative vaginal radiation

Cited by 9 publications

References 0 publications

Intracavitary brachytherapy in the treatment of gynecologic neoplasms

Intracavitary brachytherapy in the treatment of gynecologic neoplasms

The efficacy of postoperative vaginal irradiation in preventing vaginal recurrence in endometrial cancer

Brachytherapy for early endometrial carcinoma: a comparative study with long-term follow-up

Contact Info

Product

Resources

About