Treatment outcomes after adjuvant radiotherapy following surgery for patients with stage I endometrial cancer.
- Author:
Jiyoung KIM
1
;
Kyung Ja LEE
;
Kyung Ran PARK
;
Boram HA
;
Yi Jun KIM
;
Wonguen JUNG
;
Rena LEE
;
Seung Cheol KIM
;
Hye Sung MOON
;
Woong JU
;
Yun Hwan KIM
;
Jihae LEE
Author Information
- Publication Type:Original Article
- Keywords: Endometrial cancer; Intracavity radiotherapy; Conformal radiotherapy; Adjuvant radiotherapy
- MeSH: Brachytherapy; Disease-Free Survival; Endometrial Neoplasms*; Female; Follow-Up Studies; Fractures, Stress; Gynecology; Humans; Obstetrics; Pelvic Bones; Pelvis; Radiotherapy; Radiotherapy, Adjuvant*; Radiotherapy, Conformal; Recurrence; Risk Factors
- From:Radiation Oncology Journal 2016;34(4):265-272
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The purpose of this study is to evaluate the treatment outcomes of adjuvant radiotherapy using vaginal brachytherapy (VB) with a lower dose per fraction and/or external beam radiotherapy (EBRT) following surgery for patients with stage I endometrial carcinoma. MATERIALS AND METHODS: The subjects were 43 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial cancer who underwent adjuvant radiotherapy following surgery between March 2000 and April 2014. Of these, 25 received postoperative VB alone, while 18 received postoperative EBRT to the whole pelvis; 3 of these were treated with EBRT plus VB. The median EBRT dose was 50.0 Gy (45.0–50.4 Gy) and the VB dose was 24 Gy in 6 fractions. Tumor dose was prescribed at a depth of 5 mm from the cylinder surface and delivered twice per week. RESULTS: The median follow-up period for all patients was 57 months (range, 9 to 188 months). Five-year disease-free survival (DFS) and overall survival (OS) for all patients were 92.5% and 95.3%, respectively. Adjuvant radiotherapy was performed according to risk factors and stage IB, grade 3 and lymphovascular invasion were observed more frequently in the EBRT group. Five-year DFS for EBRT and VB alone were 88.1% and 96.0%, respectively (p = 0.42), and 5-year OS for EBRT and VB alone were 94.4% and 96%, respectively (p = 0.38). There was no locoregional recurrence in any patient. Two patients who received EBRT and 1 patient who received VB alone developed distant metastatic disease. Two patients who received EBRT had severe complications, one each of grade 3 gastrointestinal complication and pelvic bone insufficiency fracture. CONCLUSION: Adjuvant radiotherapy achieved high DFS and OS with acceptable toxicity in stage I endometrial cancer. VB (with a lower dose per fraction) may be a viable option for selected patients with early-stage endometrial cancer following surgery.
