Vaginal brachytherapy for endometrial cancer

被引:4
|
作者
Hass, Peter [1 ]
Seinsch, Selvi [2 ]
Eggemann, Holm [2 ]
Ignatov, Tanja [2 ]
Seitz, Stephan [3 ]
Ignatov, Atanas [2 ]
机构
[1] Otto von Guericke Univ, Dept Radiat Oncol, Magdeburg, Germany
[2] Otto von Guericke Univ, Dept Obstet & Gynecol, G Hauptmann Str 35, D-39108 Magdeburg, Germany
[3] Univ Med Ctr Regensburg, Dept Gynecol & Obstet, Regensburg, Germany
关键词
Endometrial cancer; VBT; EBRT; PHASE-III TRIAL; EXTERNAL-BEAM RADIOTHERAPY; INTERMEDIATE-RISK; ADJUVANT CHEMOTHERAPY; PELVIC RADIOTHERAPY; RADIATION-THERAPY; MRC ASTEC; STAGE IB; CARCINOMA; IRRADIATION;
D O I
10.1007/s00432-018-2659-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
There is limited information about survival effect of vaginal brachytherapy (VBT) and its comparison to external beam pelvic radiotherapy (EBRT) and no radiotherapy (no-RT) of endometrial cancer patients. We performed a multicenter retrospective registry study of 1550 patients with endometrial cancer treated by no-RT (n = 702), VBT (n = 430) and EBRT +/- VBT (n = 418). The outcome measure was overall survival. RT did not improve the overall survival of patients with a low risk of recurrence. In univariate analysis, the survival effect of VBT was significant in patients with intermediate and high risk of recurrence (HR 0.42, CI 0.29-0.60, p < 0.0001). EBRT +/- VBT demonstrated no survival effect in these groups. Multivariate analysis showed that VBT (HR 0.50, CI 0.36-0.71) significantly reduced the mortality risk in patients with an intermediate and high risk compared with no-RT after adjustment for age, tumor grading, tumor stage, lymphadenectomy, adjuvant therapy and comorbidities. Matching for age, histological type, tumor stage, tumor grade, and performance status between patients treated with no-RT and VBT was performed. The matching analysis again demonstrated the favorable survival effect of VBT compared to no-RT on overall survival with an absolute risk reduction of 17.7%. Notably, in a further 106 matched pairs, EBRT +/- VBT did not demonstrate any survival effect over VBT among patients at intermediate and high risk of recurrence. VBT should be performed in patients at intermediate and high risk of recurrence of endometrial cancer, after operative determination of lymph node status.
引用
收藏
页码:1523 / 1530
页数:8
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