POSTOPERATIVE RADIATION-THERAPY FOR SURGICALLY STAGED ENDOMETRIAL CANCER - IMPACT OF TIME FACTORS (OVERALL TREATMENT TIME AND SURGERY-TO-RADIATION INTERVAL) ON OUTCOME
Nr. Ahmad et al., POSTOPERATIVE RADIATION-THERAPY FOR SURGICALLY STAGED ENDOMETRIAL CANCER - IMPACT OF TIME FACTORS (OVERALL TREATMENT TIME AND SURGERY-TO-RADIATION INTERVAL) ON OUTCOME, International journal of radiation oncology, biology, physics, 33(4), 1995, pp. 837-842
Citations number
23
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
Purpose: To evaluate the impact of prolonged overall radiation treatme
nt (RT) time and surgery-to-radiation interval on local control (LC) a
nd disease-specific survival (DSS) of surgically staged endometrial ca
ncer patients in relation to known prognostic factors. Methods and Mat
erials: Between 1971 and 1993, 195 endometrial cancer patients receive
d postoperative RT at the Fox Chase Cancer Center, All patients underw
ent total abdominal hysterectomy (TAH), with 38% also having lymph nod
e sampling, All patients received whole pelvic external beam RT to a m
edian dose of 45 Gy (range 40 to 60 Gy). Sixty-nine percent received a
vaginal cuff boost with either low dose rate or high dose rate brachy
therapy, Tumor and treatment factors were analyzed for impact on LC an
d DSS, Median follow-up was 47 months (range: 6 to 187 months). Result
s: The overall actuarial 5-year LC rate was 85%. In multivariate analy
sis, tumor grade, pathologic stage, external radiation dose, and surgi
cal lymph node evaluation were independent prognostic variables for im
proved LC. Surgery-to-radiation interval of greater than 6 weeks was a
marginally significant factor for decreased LC (p = 0.06), Overall RT
time and external beam treatment time did not appear to impact LC rat
es, The overall actuarial 5-year DSS rate was 86%. In multivariate ana
lysis, depth of myometrial invasion, tumor grade, and pathologic stage
were independent prognostic variables for DSS, In addition, a surgery
-to-radiation interval of greater than 6 weeks was significantly assoc
iated with decreased DSS (p < 0.005). Conclusions: Surgery-to-radiatio
n interval of greater than 6 weeks is a significant independent progno
stic variable for decreased DSS and a marginally significant variable
for decreased LC in patients irradiated postoperatively for endometria
l cancer, Other time factors (overall RT time and external beam treatm
ent time) did not appear to impact outcome, Based on this analysis, po
stoperative radiation therapy for endometrial cancer should be initiat
ed within 6 weeks following surgery.