Preoperative radiotherapy in stage I/II endometrial adenocarcinoma

Autor: Sébastien Salas, M. M. Padeano, J. Fraisse, M.C. Bone-Lepinoy, Isabelle Barillot, S. Douvier, Philippe Maingon, J. Cuisenier, Jean-Claude Horiot, F. Collin
Rok vydání: 1996
Předmět:
Zdroj: Radiotherapy and Oncology. 39:201-208
ISSN: 0167-8140
DOI: 10.1016/0167-8140(96)01743-4
Popis: From 1972 to 1993,170 patients received preoperative radiotherapy followed, 5–6 weeks later, by total extrafascial hysterectomy with bilateral salpingo-oophorectomy without lymphadenectomy. Eighty-three patients with good prognostic factors (low grade tumour and no cervical involvement) received low dose rate utero vaginal brachytherapy alone before surgery (Group 1). Eighty-seven patients with poor prognostic factors (high grade tumors and/or cervical involvement) received external radiotherapy to 40 Gy and low dose rate brachytherapy before surgery (Group 2). A single vaginal failure was observed (0.6%). The overall pelvic failure rate was 2.3% (four patients) including two cases with pelvic recurrence and metastases. Three of the four pelvic failures occurred in Group 1. Using the 1971 FIGO clinical staging, 5-year disease-free survival was 82% in Stage Ia, 79% in Stage Ib, and 81% in Stage II ( P = 0.36). Five-year disease-free survival was 86% in Grade 1, 76% in Grade 2, and 83% in Grade 3 ( P = 0.20). Five-year overall survival was 83% in Stage Ia, 79% in Stage Ib, and 83% in Stage II ( P = 0.78). Five-year overall survival was 88% in Grade 1, 77% in Grade 2,83% in Grade 3 ( P = 0.27). Complications were recorded with the French-Italian syllabus. Grade 2 complications occurred in 12 cases (7%), Grade 3 in five cases (3%). The lack of correlation between classical risk factors (stage, grade) and disease outcome suggests that preoperative radiotherapy strategies should be preferred when such factors can be identified before surgery.
Databáze: OpenAIRE
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