Journal article
Neoadjuvant Chemoradiation Therapy Followed by Extrafascial Hysterectomy in Locally Advanced Type II Endometrial Cancer Clinically Extending to Cervix
Practical radiation oncology, v 9(4), pp 248-256
Jul 2019
PMID: 30802615
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The role of neoadjuvant chemoradiation therapy in locally advanced type II endometrial cancer is controversial. We thus aimed to present our experience with the hypothesis that neoadjuvant chemoradiation therapy is associated with similarly high rates of downstaging and locoregional control for type II endometrial cancer and type I endometrial cancer.
Thirty-four patients with type II endometrial cancer with clinical evidence of cervical ± parametrium involvement treated with neoadjuvant external beam radiation therapy (45-50.4 Gy in 25-28 fractions) and high-dose-rate brachytherapy with a median total dose of 20 Gy (range, 15-27.5) in 4 fractions (range, 3-5) and concurrent platinum chemotherapy ± adjuvant chemotherapy from 2008 to 2018 were retrospectively reviewed. Patients with type I pathologic diagnoses and those treated with definitive (rather than preoperative) intent were excluded.
Pathologic characteristics were as follows: 38% were carcinosarcoma, 18% serous, and 24% clear cell. Ninety-four percent of patients were downstaged to an extrafascial hysterectomy, and 94% had negative surgical margins. The 2-year local control, regional control, distant control, disease-free survival, and overall survival were 87.8%, 81.3%, 76.3%, 52.5%, and 63.7%, respectively. There was 1 subacute grade 3 and 1 late grade 3 small bowel obstruction, directly attributable to radiation therapy.
Neoadjuvant chemoradiation therapy effectively downstages the majority of locally advanced type II endometrial cancers, thereby increasing the likelihood of achieving complete resection with negative margins.
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Details
- Title
- Neoadjuvant Chemoradiation Therapy Followed by Extrafascial Hysterectomy in Locally Advanced Type II Endometrial Cancer Clinically Extending to Cervix
- Creators
- Uzoma K Iheagwara - UPMC Hillman Cancer CenterJohn A Vargo - UPMC Hillman Cancer CenterKatherine S Chen - UPMC Hillman Cancer CenterDanielle R Burton - UPMC Hillman Cancer CenterSarah E Taylor - Magee-Womens HospitalJessica L Berger - Magee-Womens HospitalMichelle M Boisen - UPMC Hillman Cancer CenterJohn T Comerci - UPMC Hillman Cancer CenterBrian C Orr - Magee-Womens HospitalPaniti Sukumvanich - Magee-Womens HospitalAlexander B Olawaiye - Magee-Womens HospitalJoseph L Kelley - Magee-Womens HospitalRobert P Edwards - Magee-Womens HospitalMadeleine B Courtney-Brooks - UPMC Hillman Cancer CenterSushil Beriwal - UPMC Hillman Cancer Center
- Publication Details
- Practical radiation oncology, v 9(4), pp 248-256
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000472574100024
- Scopus ID
- 2-s2.0-85063212414
- Other Identifier
- 991021897388604721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging