Adjuvant Radiotherapy in the Therapy of Uterus Body Cancerin the First Clinical Stage

Overview

Objective:
The aim of our study was to fi nd the infl uence of the postoperative radiotherapy on localcontrol and overal survival in patients with carcinoma of the uterus. Endometrial carcinomais the most frequent gynecologic malignity. Surgery, radiotherapy, chemotherapy and hormonaltherapy are used in the treatment of this disease. The optimal cure strategy has not been establishedyet.Design: retrospective study.Setting: Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno.Methods: We followed up 246 patients with the diagnosis of endometrial carcinoma. All patientswere in clinical stage 1. Median of the age was 60 years. Every patient underwent radical hysterectomyand adnexectomy. Most of them had adjuvant radiotherapy. Combined radiotherapywas used (external beam radiotherapy and brachyradiotherapy). Some of patients underwentonly external beam radiotherapy, other had only brachytherapy. We used Kaplan-Meier survivalfunction and methods of Statistica.Results: The median of the follow up was 8.3 years. Local recurrence was proved in 16 cases. Thetime to the local relapse was 3.2 years. Dissemination occurred in 12 patients. The time to theprogression was 5.9 years. Five-year DFS was 80.9%, fi ve-year overal survival was 82.9%. Patients,who had risk factors, were proved to suffer from worse overal survival. The adjuvant radiotherapyimproved the local, and the distant control in the group of patients with risk factors.Conclusion: The infl uence of the radiotherapy on the local control was proved in many studies,the infl uence on the overal survival was not statistically signifi cant. Temporally there is the optionnot to apply adjuvant radiotherapy. Our study shows the important benefi t of the adjuvanttreatment in cases of endometrial carcinoma and risk factors.

Key words:
endometrial carcinoma, adjuvant radiotherapy