Adjuvant vaginal high-dose-rate afterloading alone in endometrial carcinoma: patterns of relapse and side effects following low-dose therapy.

Abstract

OBJECTIVE:

This retrospective study was conducted to document the incidence and location of recurrences as well as the rate of side effects following low-dose postoperative high-dose-rate (HDR) brachytherapy in patients with endometrial carcinoma.

METHODS:

From 1987 to 1993, 122 patients with moderate-risk (78) and high-risk (44) endometrial carcinoma underwent adjuvant vaginal irradiation. All patients received three fractions of 7 Gy specified on the surface of the vaginal cylinder.

RESULTS:

Relapses occurred in 12 (9. 8%) patients on average after 25.6 months. Seven (5.7%) patients had a sole pelvic recurrence; in 2 (1.6%) of those the relapse was located in the vagina only. Three (2.5%) patients had a pelvic relapse combined with distant metastases. Distant metastases alone were diagnosed in 2 (1.6%) patients. A tumor recurrence was diagnosed in 3 of 78 (3.8%) patients with moderate-risk disease and in 9 of 44 (20.5%) patients with high-risk disease. The estimated 5-year relapse-free survival was 94% for patients with moderate-risk and 74% for patients with high-risk tumors (P = 0.004). Neither severe nor chronic complications were noted.

CONCLUSION:

Even low doses of HDR brachytherapy seem sufficient for excellent vaginal disease control in moderate-risk disease. In advanced tumors combined radiation therapy is warranted for improved pelvic disease control.

• Authors: E Weiss, P Hirnle, H Arnold-Bofinger, C F Hess, M Bamberg
• Journal: Gynecologic oncology (Gynecol Oncol) Vol. 71 Issue 1 Pg. 72-6 (Oct 1998) ISSN: 0090-8258 [Print] United States
• PMID: 9784322 (Publication Type: Journal Article)
• Copyright: Copyright 1998 Academic Press.

Topics

• Aged
• Aged, 80 and over
• Brachytherapy (adverse effects, methods)
• Endometrial Neoplasms (mortality, pathology, radiotherapy)
• Female
• Humans
• Middle Aged
• Neoplasm Metastasis (pathology)
• Neoplasm Recurrence, Local (pathology)
• Radiotherapy, Adjuvant (adverse effects)
• Retrospective Studies
• Survival Rate