Evaluation of Uterine Brachytherapy as Primary Treatment Option for Elderly Patients with Medically Inoperable Endometrial Cancer-A Single-Center Experience and Review of the Literature.

Autor:	Arians N; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.; National Center for Tumor diseases (NCT), 69120 Heidelberg, Germany., Oelmann-Avendano JT; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Department of Radiation Oncology, Göttingen University Hospital, 37075 Göttingen, Germany., Schmitt D; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Department of Radiation Oncology, Göttingen University Hospital, 37075 Göttingen, Germany., Meixner E; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.; National Center for Tumor diseases (NCT), 69120 Heidelberg, Germany., Wark A; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.; National Center for Tumor diseases (NCT), 69120 Heidelberg, Germany., Hoerner-Rieber J; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.; National Center for Tumor diseases (NCT), 69120 Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany., El Shafie RA; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.; National Center for Tumor diseases (NCT), 69120 Heidelberg, Germany., Lang K; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.; National Center for Tumor diseases (NCT), 69120 Heidelberg, Germany., Wallwiener M; Department of Gynecology and Obstetrics, Heidelberg University Hospital, 69120 Heidelberg, Germany., Debus J; Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.; Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany.; National Center for Tumor diseases (NCT), 69120 Heidelberg, Germany.; Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.; Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, 69120 Heidelberg, Germany.; German Cancer Consortium (DKTK), 69120 Heidelberg, Germany.
Jazyk:	angličtina
Zdroj:	Cancers [Cancers (Basel)] 2020 Aug 15; Vol. 12 (8). Date of Electronic Publication: 2020 Aug 15.
DOI:	10.3390/cancers12082301
Abstrakt:	We aimed to gain more evidence regarding the feasibility, toxicity, and oncological outcome of primary brachytherapy in patients with medically inoperable endometrial cancer. Thirteen patients receiving primary brachytherapy ± external beam radiotherapy (EBRT) for endometrial cancer due to medical inoperability were identified. The Kaplan-Meier method was used to estimate overall survival (OS), progression-free survival (PFS), and local failure-free survival (LFFS). Univariate outcome analyses were performed using the log-rank test. Peri-interventional complications, acute and chronic toxicities were evaluated. Additionally, we performed a Pubmed search and review of the literature of the last 10 years. Mean age at time of diagnosis was 73.9 years (60.4-87.1 years). Eleven patients were staged FIGO IA/B and one patient each with FIGO IIIA and IIIC. Kaplan-Meier-estimated 2-/5-year LFFS were 76.2%/56.4%, respectively. High grading correlated with a worse LFFS ( p = 0.069). Kaplan-Meier-estimated 2-/5-year PFS were 76.9%/53.8% and 2-/5-year-OS were 76.9%/69.2%, respectively. No acute toxicities > grade II and only two late toxicities grade II/III occurred. We observed three peri-interventional complications. The available evidence suggests high rates of local control after definitive brachytherapy for inoperable endometrial cancer with a favorable toxicity profile. Definitive brachytherapy +/- EBRT should be considered as the preferred approach for this patient group.
Databáze:	MEDLINE
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