POSTOPERATIVE RADIOTHERAPY FOR PATIENTS WITH HIGH-RISK ENDOMETRIAL CARCINOMA: A CLINICAL EVALUATION OF ONE INSTITUTION’S RESULTS

DOI 25 References
  • KOTANI Shouko
    Department of Radiology, Kitasato University School of Medicine
  • NIIBE Yuzuru
    Department of Radiology, Kitasato University School of Medicine
  • JOBO Toshiko
    Department of Obstetrics and Gynecology, Kitasato University School of Medicine
  • TSUNODA Shimpei
    Department of Obstetrics and Gynecology, Kitasato University School of Medicine
  • IMAI Manami
    Department of Obstetrics and Gynecology, Kitasato University School of Medicine
  • KITANO Masashi
    Department of Radiology, National Hospital Oraganization Sagamihara National Hospital
  • ISHIYAMA Hiromichi
    Department of Radiology, Kitasato University School of Medicine
  • MATSUBAYASHI Takashi
    Department of Radiology, Kitasato University School of Medicine
  • UNNO Nobuya
    Department of Obstetrics and Gynecology, Kitasato University School of Medicine
  • HAYAKAWA Kazushige
    Department of Radiology, Kitasato University School of Medicine

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Other Title
  • 局所再発high-risk群の子宮体癌に対する術後放射線治療成績

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Abstract

Purpose: A postoperative adjuvant therapy for high-risk endometrial carcinoma remains controversial due to its indication and method. To evaluate postoperative radiotherapy for endometrial carcinoma with high-risk factors of local recurrence, we retrospectively analyzed the patients treated in our institution.<br>Materials and Methods: We analyzed the 43 patients receiving curative surgery and postoperative radiotherapy for high-risk endometrial carcinoma in our institution from January 1994 to December 2003. The diseases were classified as surgical stage IB-IIIC (The General Rules for Clinical and Pathological Management of Uterine Corpus Cancer, The 2nd Edition). The numbers of cases are as follows: 2 cases in IB, 21 in IC, 7 in IIA, 3 in IIB, 3 in IIIA, 7 in IIIC, 39 in endometrioid adenocarcinoma (Grade 1: 19, Grade 2: 12, Grade 3: 8), 3 in adenosquamous carcinoma, 1 in adenoacanthoma, respectively. Patients were treated with 4 or 10 MV X-ray using 1.8–2.0 Gy once daily fractionation, and a total dose ranged from 45 to 50.4 Gy (median, 50 Gy). The whole pelvis was irradiated, and in one patient the para-aortic nodal region was also irradiated. The follow-up time ranged from 12.6–124.9 months (median, 39.6 months).<br>Results: The 3-year local control rate and overall survival rate were 93.8% and 91.8%, respectively. There were six patients with local or distant failure. Local recurrence was observed in cases of stage IC, distant failure was observed in cases of stage IC-III. The grade ≥3 ileus (including Grade4) was observed in four patients as adverse events.<br>Conclusion: The treatment result of postoperative radiotherapy for high-risk endometrial carcinoma of stage IB-IIIC received curative surgery in our institution was considered acceptable in light of many clinical reports. The problems to be solved involve developing radiotherapy to decrease adverse events plus establishing construction strategies and stratification including chemotherapy and vaginal brachytherapy. (Article in Japanese)

Journal

  • The Journal of JASTRO

    The Journal of JASTRO 19 (4), 237-243, 2007

    Japanese Society for Therapeutic Radiology and Oncology

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