Radiation therapy for endometrial cancer in patients treated for postoperative recurrence
| Autor: | John M. Malone, Wayne S. Court, Gunter Deppe, Arthur T. Porter, Falah Shamsa, Ihn Han, C. Christensen, Kimberly Hart, Paul J. Chuba |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Vaginal Neoplasms medicine.medical_treatment Brachytherapy Recurrence Risk Factors medicine Humans Radiology Nuclear Medicine and imaging Lymph node Survival analysis Aged Retrospective Studies Aged 80 and over Radiation business.industry Endometrial cancer Retrospective cohort study Middle Aged medicine.disease Surgery Endometrial Neoplasms Radiation therapy medicine.anatomical_structure Treatment Outcome Oncology Adenocarcinoma Female Sarcoma business |
| Zdroj: | International journal of radiation oncology, biology, physics. 41(1) |
| ISSN: | 0360-3016 |
| Popis: | Purpose: To retrospectively evaluate the outcome and risk factors in patients treated with radiation for endometrial cancer at time of recurrence. Materials and Methods: Three hundred ninety-nine women were treated with radiation therapy for endometrial cancer at KCI/WSU from January 1980 to December 1994. Of these, 26 patients treated primarily with surgery received radiation therapy at the time of recurrence. Median time to recurrence after surgery was 8 months, with all recurrences occurring within 24 months. Twenty-four patients had recurrences in the vaginal cuff, vagina, or pelvis. These patients received external-beam radiation to the pelvis (45.00–50.40 Gy) and periaortic lymph nodes (45.00–50.00 Gy), along with a boost given by external-beam radiation or brachytherapy (16.00–30.00 Gy). Mean follow-up was 15 months (range 1–85 months). Results: The 2-year survival was 50% and median survival was 16 months (survival range 1–85 months). Of 26 patients, 54% (14) failed locally following radiation therapy. Factors indicative of poor survival included histology (sarcoma, poorly differentiated adenocarcinoma), grade, and lymph node positivity. Histological differentiation influenced local control; lymphovascular space invasion was of borderline significance with regard to local control. Conclusion: Local control and survival for surgically treated endometrial cancer patients who receive radiation at the time of recurrence are poor, with the exception of those patients with recurrent disease limited to the vagina. Early detection of recurrence may improve outcome. Pathologic risk factors may identify those patients at risk for extrapelvic recurrence. Alternative treatment modalities need to be developed for this high-risk group of patients. |
| Databáze: | OpenAIRE |
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