Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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The Results of Postoperative Radiotherapy for Early Stage Endometrial Carcinoma

초기 자궁내막암의 수술 후 방사선치료의 결과

  • Kang Min-Kyu (Departments of Radiation Oncology and Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park Won (Departments of Radiation Oncology and Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee Jeong-Won (Departments of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim Byounq-Gie (Departments of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Bae Duk-Soo (Departments of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee Je-Ho (Departments of Obstetrics & Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee Ki-Heon (Department of Obstetrics & Gynecology, Cheil General Hospital & Women's Healthcare Center, Sungkyunkwan University School of Medicine) ;
  • Lim Kyung-Taek (Department of Obstetrics & Gynecology, Cheil General Hospital & Women's Healthcare Center, Sungkyunkwan University School of Medicine) ;
  • Kim Tae-Jin (Department of Obstetrics & Gynecology, Cheil General Hospital & Women's Healthcare Center, Sungkyunkwan University School of Medicine) ;
  • Seong Seok-Ju (Department of Obstetrics & Gynecology, Cheil General Hospital & Women's Healthcare Center, Sungkyunkwan University School of Medicine) ;
  • Park Chong-Taik (Department of Obstetrics & Gynecology, Cheil General Hospital & Women's Healthcare Center, Sungkyunkwan University School of Medicine) ;
  • Lee Jeong-Eun (Departments of Radiation Oncology and Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Huh Seung-Jae (Departments of Radiation Oncology and Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 강민규 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 박원 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 이정원 (성균관대학교 의과대학 삼성서울병원 산부인과) ;
  • 김병기 (성균관대학교 의과대학 삼성서울병원 산부인과) ;
  • 배덕수 (성균관대학교 의과대학 삼성서울병원 산부인과) ;
  • 이제호 (성균관대학교 의과대학 삼성서울병원 산부인과) ;
  • 이기헌 (성균관대학교 의과대학 제일병원 산부인과) ;
  • 임경택 (성균관대학교 의과대학 제일병원 산부인과) ;
  • 김태진 (성균관대학교 의과대학 제일병원 산부인과) ;
  • 성석주 (성균관대학교 의과대학 제일병원 산부인과) ;
  • 박종택 (성균관대학교 의과대학 제일병원 산부인과) ;
  • 이정은 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 허승재 (성균관대학교 의과대학 삼성서울병원 방사선종양학과)
  • Published : 2006.06.01
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Abstract

Purpose: To determine treatment policy for early stage endometrial carcinoma, we analyzed the results of postoperative radiotherapy. Materials and Methods: From Oct. 1994 to Aug. 2002, 42 patients with FIGO stage I endometrial carcinoma received postoperative radiotherapy. All patients received curative surgery and pelvic lymph node dissection was done in 25 patients. Based on the FIGO staging system, 3 were at stage IA, 21 were at stage IB and 18 were at stage IC. Histologically, there were 14 grade 1, 16 grade 2, and 12 grade 3. Nineteen patients received intracavitary brachytherapy and 23 patients did whole pelvic radiotherapy. The median period of follow-up was 41 months (22 to 100 months). Results: Five-year overall survival, disease-free survival, local control, and regional control rates of all patients were 85.0%, 87.9%, 100%, and 97.5%, respectively. All failures were distant metastases in 5 patients and two patients had simultaneous regional recurrences. There was no intrapelvic failure in patients who received intracavitary radiotherapy. Grade 3 chronic complications were found in 1 patient (4.3%), who received whole pelvic radiotherapy. Conclusion: We achieved high rates of loco-regional control and survival by curative surgery and post-operative radiotherapy. However, we need to select the type of radiotherapy based on the risk factors for recurrence to reduce the treatment-related complication.

목적: 본 연구는 수술 후 방사선치료를 받은 초기 자궁내막암의 치료결과를 분석하여 향후 치료방침 결정에 도움을 주고자 한다. 대상 및 방법: 1994년 10월부터 2002년 8월까지 FIGO I 병기의 자궁내막암으로 수술 후 방사선치료를 받은 환자는 총 42명이었다. 모든 환자들이 근치적 수술을 시행하였으며, 골반림프절곽청술은 26명에서 시행되었다. FIGO 병기는 IA 병기 3명, IB 병기 21명, IC 병기 18명이었고, 조직학적 등급은 1등급 14명, 2등급 16명, 3등급 12명이었다. 19명의 환자는 강내근접치료를 받았으며, 23명은 전골반-방사선치료를 받았다. 추적관찰기간은 $22{\sim}100$개월(중앙값 41개월)이었다. 결과: 전체 환자의 5년 생존율, 무병생존율, 국소제어율, 영역제어율은 각각 86.0%, 87.9%, 100%, 97.5%였다. 재발은 원격전이가 5명에서 발생하였는데, 이들 중 2명은 영역재발이 동반되었다. 강내근접치료만 받은 환자들에서는 국소영역재발이 없었다. 3등급의 만성합병증은 전골반-방사선치료를 받은 1명(4.3%)에서 발생하였다. 결론: 초기 자궁내막암은 근치적 수술과 수술 후 보조적 방사선치료로 높은 국소영역제어율과 생존율을 얻을 수 있었다. 그러나 치료에 의한 부작용을 줄이기 위해서는 위험인자에 따라 방사선치료 방법을 선택하여야 할 것이다.

Keywords

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