External pelvic radiation therapy in stage IC endometrial carcinoma

Objective: To evaluate outcomes of patients with stage IC endometrial carci noma treated with external whole pelvic radiation but not vaginal brachythe rapy. Methods: Sixty-one women with stage IC endometrial carcinoma had postoperat ive pelvic radiation without vaginal brachytherapy. The median age was 69 y ears (range 44-87 years). Most subjects had histologic findings of adenocar cinoma (71%) and grade 2 or 3 disease (74%). The median pelvic irradiation dose was 48.6 Gy (range 43.2-50.4 Gy). No patients received adjuvant chemot herapy or hormonal therapy. The median follow-up time was 69.5 months (rang e 7-196 months). Results: The 5-year actuarial disease-free and overall survivals of the ent ire group were 86.7% and 97.6%, respectively. No patient developed local (v aginal) recurrence. One patient had recurrent disease in the lateral pelvis . Ten patients (16.4%) had distant (extrapelvic) metastases. No serious seq uelae were noted, including vaginal necrosis, small bowel obstruction, proc titis, or fistulae. Conclusion: Local control was excellent in stage IC endometrial carcinoma t reated with adjuvant radiation therapy alone. Attention needs to be focused on efforts to control extrapelvic recurrence in patients with this disease . (Obstet Gynecol 1999;93:599-602. (C) 1999 by The American College of Obst etricians and Gynecologists.).