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Adjuvant external beam therapy for pathologic stage I and occult stage II endometrial carcinoma
Author(s) -
Stryker John A.,
Velkley Donald E.,
Podczaski Edward,
Kaminski Paul
Publication year - 1991
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19910601)67:11<2872::aid-cncr2820671128>3.0.co;2-8
Subject(s) - medicine , brachytherapy , occult , stage (stratigraphy) , radiation therapy , carcinoma , surgery , pelvis , regimen , adjuvant therapy , hysterectomy , urology , nuclear medicine , radiology , chemotherapy , pathology , paleontology , alternative medicine , biology
Eighty‐six patients with pathologic Stage I or occult Stage II carcinoma of the endometrium and myometrial invasion and/or Grade 2 or Grade 3 histologic condition received whole‐pelvis external radiation therapy (RT) after extrafascial total abdominal hysterectomy and bilateral salpingo‐oophorectomy. Twenty‐one patients received 4250 cGy in 25 daily fractions for 5 weeks (Group 1), 28 received 4500 cGy in 25 daily fractions for 5 weeks (Group 2), and 37 received 5100 cGy in 30 daily fractions for 6 weeks (Group 3). Seventeen patients had intravaginal brachytherapy after whole‐pelvis RT. Local recurrence developed in two patients (2.3%) (one in Group 1 and one in Group 2). Statistical analysis showed that the depth of myometrial invasion significantly influenced survival ( P = 0.016). Tumor grade, pathologic stage, whole‐pelvis radiation dose, and the use of brachytherapy did not influence survival. Complications occurred in 9.5% of patients in Group 1, 24.7% in Group 2, and 40.5% in Group 3. Three patients who received brachytherapy had rectal injuries. The authors conclude that 4250 cGy in 25 fractions for 5 weeks of whole‐pelvis RT appears to induce fewer complications than higher doses, and may be sufficient to prevent local recurrence in most patients who require adjuvant RT. A clinical trial is needed to determine the optimum dose—time—fractionation regimen.