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Treatment outcomes after adjuvant radiotherapy following surgery for patients with stage i endometrial cancer

Treatment outcomes after adjuvant radiotherapy following surgery for patients with stage i endometrial cancer
Kim J.Lee K.-J.Park K.-R.Ha B.Kim Y.-J.Jung W.Lee R.Kim S.C.Moon H.S.Ju W.Kim Y.H.Lee J.
Ewha Authors
이경자scopus; 김승철scopus; 문혜성scopus; 이레나scopus; 주웅scopus; 김윤환scopus; 이지혜scopus; 박경란scopus
Issue Date
Journal Title
Radiation Oncology Journal
2234-1900JCR Link
Radiation Oncology Journal vol. 34, no. 4, pp. 265 - 272
Adjuvant radiotherapyConformal radiotherapyEndometrial cancerIntracavity radiotherapy
Department of Radiation Oncology
SCOPUS scopus
Document Type
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. © 2016. The Korean Society for Radiation Oncology.
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