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J Korean Soc Ther Radiol > Volume 13(4); 1995 > Article
Journal of the Korean Society for Therapeutic Radiology 1995;13(4): 377-384.
Comparative Analysis between preoperative Radiatherapy and postoperative Radiotherapy in Clinical Stage I and II Endometrial Carcinoma
Ki Chang Keum, Chang Geol Lee, Eun Ji Chung, Sang Wook Lee, Woo Cheol Kim, Sei Kyung Chang, Young Taek Oh, Chang Ok Suh, Gwi Eon Kim
Department of Radiation Oncology, Yonsei Cancer Center Yonsei University College of Medicine, Seoul, Korea.
ABSTRACT
PURPOSE:
To obtain the optical treatment method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy(pre-op R) and postoperative radiotherapy(post-op RT).
MATERIALS AND METHODS:
A retrospctive review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stage I; 12 patients, Stage II; 7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO(Bilateral Salphingoophorectomy) (Group 1) and 43 patients( Stage 1; 32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT was administered on 4-5 weeks following surgery. All patients exept 1 patient(Group2; ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55Gy(median 45Gy) in 5-6week through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180cGy per fraction. ICR doses were prescreibed to point A(20-39.6 Gy, median 39Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy, median 21Gy) in Group2.
RESULTS:
The overall 5year survival rate was 95%. No survival difference between pre-op and post-op RT group.(89.3% vs 97.7%, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1(p>0.1), but affected by presence of lymph node metastasis in post-op RT group(p<0.5). The complication rate of pre-op RT group was higher than post-op RT.(16% vs 5%)
CONCLUSION:
Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate.
Key Words: Endomerial carcinoma, Preoperative radiotherapy, Postoperative radiotherapy
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