Comparative Analysis between preoperative Radiatherapy and postoperative Radiotherapy in Clinical Stage I and II Endometrial Carcinoma.
- Author:
Ki Chang KEUM
1
;
Chang Geol LEE
;
Eun Ji CHUNG
;
Sang Wook LEE
;
Woo Cheol KIM
;
Sei Kyung CHANG
;
Young Taek OH
;
Chang Ok SUH
;
Gwi Eon KIM
Author Information
1. Department of Radiation Oncology, Yonsei Cancer Center Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Endomerial carcinoma;
Preoperative radiotherapy;
Postoperative radiotherapy
- MeSH:
Endometrial Neoplasms*;
Female;
Humans;
Lymph Nodes;
Neoplasm Metastasis;
Neoplasm, Residual;
Radiotherapy*;
Survival Rate
- From:Journal of the Korean Society for Therapeutic Radiology
1995;13(4):377-384
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To obtain the optical treatment method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy(pre-op R) and postoperative radiotherapy(post-op RT). MATERIALS AND METHODS: A retrospctive review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stage I; 12 patients, Stage II; 7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO(Bilateral Salphingoophorectomy) (Group 1) and 43 patients( Stage 1; 32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT was administered on 4-5 weeks following surgery. All patients exept 1 patient(Group2; ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55Gy(median 45Gy) in 5-6week through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180cGy per fraction. ICR doses were prescreibed to point A(20-39.6 Gy, median 39Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy, median 21Gy) in Group2. RESULTS: The overall 5year survival rate was 95%. No survival difference between pre-op and post-op RT group.(89.3% vs 97.7%, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1(p>0.1), but affected by presence of lymph node metastasis in post-op RT group(p<0.5). The complication rate of pre-op RT group was higher than post-op RT.(16% vs 5%) CONCLUSION: Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate.
