RADIATION-THERAPY AS EXCLUSIVE TREATMENT FOR MEDICALLY INOPERABLE PATIENTS WITH STAGE-I AND STAGE-II ENDOMETRIOID CARCINOMA OF THE ENDOMETRIUM

From 1975 to 1992, 54 patients with clinical Stage I and II endometrio id carcinoma of the endometrium, representing 3.5% of all such patient s, were deemed medically inoperable and exclusively received radiation therapy. A cohort of 108 operable patients adjusted for age, clinical stage, and grade served as a control group. The 5-year actuarial canc er-specific survivals for patients with Stage I inoperable, Stage II i noperable, Stage I operable, and Stage II operable disease were 80, 85 , 98, and 100%. The corresponding 5-year overall survival rates were 3 0, 24, 88, and 85%. Inoperable patients had a median disease-free inte rval of 36 months for clinical Stage I and 50 months for Stage II dise ase versus 74.5 and 77 months for the operable patients (P = 0.001). I noperable patients with Stage I disease had a median survival of 37 mo nths versus 50 months for Stage II (P = NS), with only 7 (13%) of thes e patients dying with endometrial cancer. Operable patients had a medi an survival of 75 and 79 months in Stage I and II, respectively, with 14 patients dying with endometrial carcinoma (13%). Stage I and II ino perable patients had significantly shorter survival than operable pati ents (P < 0.0001). More deaths from intercurrent disease occurred with in the inoperable Stage I group than with the operable group (28 of 32 vs 3 of 15, P < 0.0001). Inoperable patients had a significantly shor ter overall survival and more deaths due to intercurrent disease than operable patients (P < 0.0001). However, inoperable patients who did n ot die from intercurrent disease had a median 5-year survival which ap proaches that of operable patients. Our study demonstrates that exclus ive radiation therapy is a well-tolerated and effective treatment for medically inoperable patients. (C) 1996 Academic Press, Inc.