Treatment outcome of postoperative radiotherapy for patients with stage I endometrial carcinoma
Hou Xiaorong*, Hu Ke, Shen Jie, Lian Xin, Sun Shuai, Yan Junfang, Liu Zhikai, Zhang Fuquan, Li Yexiong
*Department of Radiation Oncology,Cancer Hospital,Pecking Union Medical College Hospital,Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
Abstract：Objective To retrospectively analyze the treatment outcomes and adverse reactions of265 patients with stage I endometrial carcinoma (EC) treated with postoperative radiotherapy. Methods Two hundred and sixty-five patients with stage I EC were treated with hysterectomy and postoperative adjuvant radiotherapy from 1999 to 2012. The most common histological subtype of EC was adenocarcinoma (85.3%), and patients were staged according to the FIGO 2009 guidelines. The postoperative adjuvant radiotherapy methods included pelvic external beam radiotherapy (35 patients, 13.2%), vaginal brachytherapy (107 patients, 40.4%), and a combination of them (123 patients, 46.4%).The Kaplan-Meier method was used to caculate survival rate,the log-rank test was used to for survival difference analysis,the Cox regression model was used for multivariate prognostic analysis. Results The 5-year following-up rate was 85.7%.The 5-year overall survival (OS), progression-free survival (PFS), local recurrence, and distant metastasis rates for all patients were 92.8%, 89.7%, 4.5%, and 6.4%, respectively. One patient (0.4%) developed grade 3 acute radiation enteritis, 4 patients (1.5%) and 1 patient (0.4%) developed grade 3 and 4 myelosuppression, and 1 patient (0.4%) developed grade 3 chronic enteritis;no grade 3 or greater toxicities were noted. The multivariate analysis showed that involvement of the lower uterine was a significant predictor of OS (P=0.041) and PFS (P=0.001), whereas anemia before radiotherapy was a significant predictor of OS (P=0.048). Conclusions For patients with stage I EC (mostly adenocarcinoma), postoperative radiotherapy has good efficacy and mild toxicities. Anemia before radiotherapy and involvement of the lower uterine are important predictors of OS.
Hou Xiaorong,Hu Ke,Shen Jie et al. Treatment outcome of postoperative radiotherapy for patients with stage I endometrial carcinoma[J]. Chinese Journal of Radiation Oncology, 2015, 24(1): 48-52.
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