Journal article
Long-term outcomes using adjuvant pelvic intensity modulated radiation therapy (IMRT) for endometrial carcinoma
Practical Radiation Oncology, v 7(1), pp 19-25
01 Jan 2017
PMID: 27527897
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: We evaluated the long-term outcome and toxicity of adjuvant intensity modulated radiation therapy (IMRT) for high-risk endometrial carcinoma via a retrospective institutional review of patients treated in this setting with extended follow-up.
Methods and materials: Patients with endometrial cancer who underwent comprehensive surgical staging followed by adjuvant IMRT with or without sequential chemotherapy between 1999 and 2010 were reviewed. Median doses delivered with IMRT and brachytherapy were 45 Gy in 25 fractions and 10 Gy in 2 fractions; 10.2% received extended field and 94.5% received vaginal brachytherapy. Kaplan-Meier estimates are provided for rates of locoregional (in-field) relapse, distant metastasis, and disease-free survival, and overall survival. Gastrointestinal (GI) and genitourinary (GU) toxicity reported were graded with the Common Terminology Criteria for Adverse Events, version 4.03.
Results: A total of 128 patients were identified. Median age at diagnosis was 64 years. Most patients (82.8%) had endometrioid adenocarcinoma followed by papillary serous (10.2%), clear cell (4.7%), and carcinosarcoma (2.3%). International Federation of Gynecology and Obstetrics staging distribution was as follows: IA, 13.3%; IB, 32.8%; II, 30.4%; IIIA, 5.5%; IIIC1, 9.4%; and IIIC2, 8.6%. Most (85.9%) underwent nodal dissections (28.1% pelvic only and 57.8% pelvic and para-aortic). Two patients (1.6%) experienced acute grade 3 GI toxicity; no other acute grade >= 3 GI/GU toxicities were noted. With a median follow-up of 57.0 months, 5-year locoregional relapse was 2.5%: vagina (n = 3), parametrium (n = 1), pelvic node (n = 1). Five-year estimates of distant metastasis, disease-free survival, and overall survival were 16.5%, 73.4%, and 77.4%, respectively. Five-year actuarial rates of late grade 3 GI and GU toxicities were 3.2% and 0.0%. The 5-year rate of symptomatic pelvic insufficiency fracture was 4.4%.
Conclusions: This study represents the largest cohort of endometrial cancer patients with extended follow-up receiving adjuvant IMRT. High rates of pelvic disease control and limited late toxicities demonstrate safety and efficacy of this approach in the setting of extended follow-up. (C) 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.
Metrics
Details
- Title
- Long-term outcomes using adjuvant pelvic intensity modulated radiation therapy (IMRT) for endometrial carcinoma
- Creators
- Siping He - University of PittsburghBeant S. Gill - UPMC Hillman Cancer CenterDwight E. Heron - UPMC Hillman Cancer CenterJoseph L. Kelley - Magee-Womens HospitalPaniti Sukumvanich - University of Pittsburgh Medical CenterAlexander B. Olawaiye - Magee-Womens HospitalRobert P. Edwards - Magee-Womens HospitalJohn Comerci - Magee-Womens HospitalSushil Beriwal - UPMC Hillman Cancer Center
- Publication Details
- Practical Radiation Oncology, v 7(1), pp 19-25
- Publisher
- Elsevier
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000396396100020
- Scopus ID
- 2-s2.0-84990192764
- Other Identifier
- 991021897364004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging