Less gastrointestinal toxicity after adjuvant radiotherapy on a small pelvic field compared to a standard pelvic field in patients with endometrial carcinoma

Autor: P.R. Timmer, H. Marike Boezen, Renske A. de Jong, Elisabeth Pras, Marian J.E. Mourits, Henriette J. G. Arts, Ate G. J. van der Zee, Jan G. Aalders, Hans W. Nijman, Harry Hollema, Annerie Slot
Přispěvatelé: Science in Healthy Ageing & healthcaRE (SHARE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Life Course Epidemiology (LCE), Targeted Gynaecologic Oncology (TARGON), Groningen Research Institute for Asthma and COPD (GRIAC), Translational Immunology Groningen (TRIGR)
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Gastrointestinal Diseases
medicine.medical_treatment
POSTOPERATIVE RADIOTHERAPY
ONCOLOGY-GROUP
Lymph node
Cervical cancer
Ovarian Neoplasms
Obstetrics and Gynecology
Common Terminology Criteria for Adverse Events
Middle Aged
Prognosis
Adenocarcinoma
Mucinous
medicine.anatomical_structure
STAGE-I
Oncology
Female
Radiology
medicine.medical_specialty
CERVICAL-CANCER
RISK CORPUS CANCER
Ileus
Endometrial carcinoma
Pelvis
VAGINAL BRACHYTHERAPY
medicine
Carcinoma
Humans
External beam radiotherapy
Aged
Neoplasm Staging
Radiotherapy
Toxicity
business.industry
medicine.disease
Carcinoma
Papillary
RANDOMIZED-TRIAL
Surgery
Cystadenocarcinoma
Serous
Endometrial Neoplasms
Radiation therapy
Treatment
LYMPH-NODE DISSECTION
EXTERNAL-BEAM RADIOTHERAPY
MRC ASTEC
Lymphadenectomy
Radiotherapy
Adjuvant
Neoplasm Grading
Neoplasm Recurrence
Local
business
Adenocarcinoma
Clear Cell
Follow-Up Studies
Zdroj: International Journal of Gynecological Cancer, 22(7), 1177-1186. LIPPINCOTT WILLIAMS & WILKINS
ISSN: 1048-891X
Popis: ObjectiveRadiotherapy is associated with short-term and long-term morbidity. This study compared toxicity rates among patients with endometrial carcinoma (EC) treated with adjuvant external beam radiation therapy (EBRT) on a small pelvic field (SmPF) in comparison with a standard pelvic field (StPF) or an extended field (EF).MethodsPatients with EC preoperatively diagnosed with high-grade histological disease (grade 3 endometrioid, papillary serous, clear cell, and mixed tumor type) or cervical involvement were treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymphadenectomy in the University Medical Center Groningen between 1999 and 2008. Patients who received adjuvant EBRT were included in this study. External beam radiation therapy on SmPF (includes only the central pelvis and proximal vagina) was applied in case of negative lymph nodes after adequate lymphadenectomy (≥10 lymph nodes removed at the bilateral obturator and external iliac nodal stations). In case of positive pelvic lymph nodes or inadequate lymphadenectomy, EBRT on StPF was given. External beam radiation therapy on EF was applied in case of common iliac and/or para-aortic lymph node metastases.Retrospectively, using the Common Terminology Criteria for Adverse Events v3.0, acute toxicity was scored during radiotherapy, whereas late toxicity was scored, from 3 months onward after treatment.ResultsToxicity could be evaluated in 75 patients treated with SmPF (n = 33), StPF (n = 28), and EF EBRT (n = 14). Most patients with late adverse events had also reported toxicity during radiotherapy (71%). The most common late adverse events were gastrointestinal tract related, more frequently present in the StPF group (60.7%) compared to SmPF (33.3%; P = 0.032). In particular, nausea and anorexia were more frequent in the StPF group (32.1%) compared to the SmPF group (3.0%; P = 0.004), as well as ileus (14.3% vs 0%, P = 0.039, respectively).ConclusionsTreatment with adjuvant EBRT on SmPF results in less gastrointestinal late adverse events compared to treatment with EBRT on StPF in patients with surgically staged EC.
Databáze: OpenAIRE
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