External Pelvic and Vaginal Irradiation Versus Vaginal Irradiation Alone as Postoperative Therapy in Medium-Risk Endometrial Carcinoma: A Prospective, Randomized Study—Quality-of-Life Analysis
Autor: | Karin Boman, Håkan Andersson, György Horvath, Caroline Lundgren, Bengt Sorbe, Birgitta Pettersson |
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Rok vydání: | 2012 |
Předmět: |
Adult
medicine.medical_specialty Vaginal Neoplasms medicine.medical_treatment Brachytherapy Endometrial Carcinomas Quality of life Risk Factors Carcinoma Humans Medicine Prospective randomized study Postoperative Period Prospective Studies External beam radiotherapy Aged Neoplasm Staging Pelvic Neoplasms Aged 80 and over Gynecology business.industry Obstetrics and Gynecology Middle Aged Prognosis medicine.disease Combined Modality Therapy Endometrial Neoplasms Survival Rate Oncology Quality of Life Vaginal brachytherapy Female Radiology Neoplasm Grading Neoplasm Recurrence Local Medium Risk business Follow-Up Studies |
Zdroj: | International Journal of Gynecologic Cancer. 22:1281-1288 |
ISSN: | 1525-1438 1048-891X |
DOI: | 10.1097/igc.0b013e3182643ba0 |
Popis: | BackgroundA combination of vaginal brachytherapy and external beam radiotherapy was compared with brachytherapy alone in medium-risk endometrial carcinomas. Quality-of-life analysis is an important part of a randomized study to find out the optimal adjuvant treatment for this group of patients.ObjectiveTo evaluate the value of adjuvant external beam pelvic radiotherapy in adjunct to vaginal brachytherapy in medium-risk endometrial carcinoma. Quality-of-life evaluation is the main topic of this report.MethodsA consecutive series of 527 evaluable patients were included in this randomized trial. Median follow-up for patients alive was 62 months. The primary study end points were locoregional recurrences and overall survival. Secondary end points were recurrence-free survival, toxicity, and quality-of-life. European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-OV28 modules were used to evaluate global health status, functional scales, and symptom scales.ResultsFive-year locoregional relapse rates were 1.5% after external beam (ERT) plus vaginal irradiation (VBT) and 5% after vaginal irradiation alone (P = 0.013), and 5-year overall survival (OS) rates were 89% and 90%, respectively. External beam radiotherapy was associated with a higher rate of adverse effects from the intestine and the bladder, and quality-of-life parameters deteriorated at the end of radiotherapy but recovered to normal levels within a few months. There was a significant difference in favor of VBT alone with regard to adverse effects of the bowel and urinary tract, and quality-of-life.ConclusionsDespite a significant locoregional control benefit with combined radiotherapy, no survival improvement was recorded; but increased late toxicity from the intestine and the bladder. External beam irradiation decreased global health status during and after treatment, and 3 functional scale items (physical, role, and social). Six of 11 symptom items showed a pattern favoring vaginal brachytherapy alone. |
Databáze: | OpenAIRE |
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