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J Korean Soc Ther Radiol Oncol > Volume 25(2); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(2): 93-100.
The Results of Postoperative Radiotherapy for Endometrial Carcinoma
O Kyu Noh, Seong Soo Shin, Sang Wook Lee, Seung Do Ahn, Eun Kyung Choi, Jong Hyeok Kim, Yong Man Kim, Joo Hyun Nam, Jung Eun Mok, Jong Hoon Kim
1Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ssskjy@amc.seoul.kr
2Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
To evaluate the outcome and prognostic factors of postoperative radiotherapy in endometrial carcinoma.
From September 1991 to August 2003, 76 patients with endometrial carcinoma received postoperative adjuvant radiotherapy after hysterectomy at Asan Medical Center. Stage was classified as FIGO I in 41 (53.9%), II in 12 (53.9%), and III in 23 (30.3%). Histologic grade 1, 2 and 3 were in 29 (38.2%), 20 (26.3%), and 27 (35.5%) respectively. Forty two patients received both external beam radiation therapy (EBRT) and intracavitary radiation (ICR), 34 patients were treated with EBRT or ICR alone. EBRT dose was 50.4 Gy, ICR was performed in 4~6 fractions with 4~5 Gy per fraction. Median follow?up period was 51 (range 5~121) months.
Five-year overall survival was 89.6%. In univariate analysis, statistically significant factors to overall survival were FIGO stage, lymph node metastasis and histologic grade. In disease free survival, FIGO stage, lymph node metastasis and lymphovascular invasion were significant prognostic factors. Recurrence was seen in 11 patients. Of these, systemic failure was in 10 patients. There were no moderate to severe complications after radiation therapy.
The outcome of postoperative adjuvant radiotherapy in endometrial carcinoma was good. Main pattern of failure after postoperative radiotherapy was distant metastasis. So, adjuvant chemotherapy may help in improving outcome. Further study on chemotherapy in combined with postoperative radiotherapy will be needed, especially for patients with high risk factors such as high FIGO stage, lymphovascular invasion, and high histologic grade.
Key Words: Endometrial carcinoma, Radiotherapy, Prognostic factor
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