Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Treatment outcomes after adjuvant radiotherapy following surgery for patients with stage I endometrial cancer

  • Kim, Jiyoung (Department of Radiation Oncology, Ewha Womans University School of Medicine) ;
  • Lee, Kyung-Ja (Department of Radiation Oncology, Ewha Womans University School of Medicine) ;
  • Park, Kyung-Ran (Department of Radiation Oncology, Ewha Womans University School of Medicine) ;
  • Ha, Boram (Proton Therapy Center, National Cancer Center) ;
  • Kim, Yi-Jun (Department of Radiation Oncology, Ewha Womans University School of Medicine) ;
  • Jung, Wonguen (Department of Radiation Oncology, Ewha Womans University School of Medicine) ;
  • Lee, Rena (Department of Radiation Oncology, Ewha Womans University School of Medicine) ;
  • Kim, Seung Cheol (Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine) ;
  • Moon, Hye Sung (Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine) ;
  • Ju, Woong (Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine) ;
  • Kim, Yun Hwan (Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine) ;
  • Lee, Jihae (Department of Radiation Oncology, Ewha Womans University School of Medicine)
  • Received : 2016.01.26
  • Accepted : 2016.06.30
  • Published : 2016.12.31
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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.

Keywords

References

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