Department of Radiation Oncology,Pecking Union Medical College Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100730,China
Abstract： Objective To retrospectively analyze the efficacy of postoperative vaginal vault brachytherapy for early-stage endometrial carcinoma (EC). Methods One hundred and fifty-eight patients with early-stage EC who were treated with postoperative vaginal vault brachytherapy alone from 2004 to 2013 were enrolled as subjects. According to the 2009 International Federation of Gynecology and Obstetrics staging system, 105 patients had stage Ⅰ a disease and 53 had stage Ⅰ b disease. Most (142/158, 89.9%) patients had the histological subtype of adenocarcinoma. Seventeen patients were pathologically diagnosed with grade 3 disease. Iridium-192 high-dose radiation brachytherapy was applied to the top and upper 1/2 part of the vagina with a reference point at 5 mm depth of vaginal mucosa. The radiation dose was 25-30 Gy in 5-6 factions. The survival rate was calculated by the Kaplan-Meier method and analyzed by log-rank test. The Cox regression model was used for multivariate prognostic analysis. Results The 5-year sample size was 63. The 5-year overall survival (OS), progression-free survival (PFS), local recurrence, and distant metastasis rates in all patients were 97.6%, 91.9%, 2.9%, and 2.8%, respectively. No vaginal recurrence, grade ≥3 acute and chronic gastroenteritis, or grade ≥3 urethritis were found in those patients. The multivariate analysis showed that lymphovascular space involvement was an independent prognostic predictor of OS (OR=0.087, 95% CI=0.009-0.813, P=0.032) and PFS (OR=0.091, 95% CI=0.018-0.459, P=0.004). Conclusions Postoperative vaginal vault brachytherapy alone achieves satisfactory treatment outcomes in the treatment of patients with early-stage EC. Lymphovascular space involvement is an important prognostic predictor of OS and PFS.
Hou Xiaorong,Hu Ke,Shen Jie et al. Efficacy of postoperative vaginal vault brachytherapy alone for early-stage endometrial carcinoma[J]. Chinese Journal of Radiation Oncology, 2017, 26(3): 291-295.
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