Author/Editor		Sorbe, B; Nordstrom, B; Maenpaa, J; Kuhelj, J; Kuhelj, D; Okkan, S; Delaloye, JF; Frankendal, B
Title		Intravaginal brachytherapy in FIGO stage I low-risk endometrial cancer: a controlled randomized study
Type		članek
Source		Int J Gynecol Cancer
Vol. and No.		Letnik 19, št. 5
Publication year		2009
Volume		str. 873-8
Language		eng
Abstract		The purpose of the study was to compare postoperative vaginal irradiation with surgery alone in low-risk International Federation of Gynecology and Obstetrics (FIGO) stage IA-IB endometrial carcinoma. The study was a prospective, randomized trial of 645 evaluable low-risk endometrial carcinoma patients from 6 European gynecologic cancer centers. All tumors were in FIGO stage IA-IB, of endometrioid histological type, and FIGO grade 1-2. High-dose-rate afterloading equipments (iridium [Ir] 192 or cobalt [co] 60) were used at 5 centers, and low-dose-rate (LDR) afterloading equipment (cesium [Cs] 137) at 1 center. Perspex vaginal applicators or ovoids were normally used, and the dose was specified at 5 mm from the surface of the applicator. Three to 6 fractions (3.0-8.0 Gy) were given, and the overall treatment time was 4 to 15 days. A total of 319 patients were treated with surgery plus vaginal irradiation (treatment group), and 326 patients with surgery alone (control group).Twenty-six recurrences (4.0%) were recorded in the complete series. The locoregional recurrence rate was 2.6%, whereas distant metastases occurred in 1.4%. The rate of vaginal recurrences was 1.2% in the treatment group versus 3.1% in the control group. The difference was not statistically significant (P = 0.114). Side effects were few and mild (grade 1-2). Dysuria, frequency, and incontinence were slightly more common after vaginal irradiation (2.8% vs 0.6%, respectively). Late intestinal problems were few and similar in the 2 groups. The conclusions were that the impact of postoperative brachytherapy on even the locoregional recurrence rate seems to be limited in patients with low-risk endometrial carcinoma. The overall recurrence rate and survival were similar in the 2 groups.
Descriptors		ADULT AGED AGED, 80 AND OVER BRACHYTHERAPY CARCINOMA, ENDOMETRIOID CESIUM RADIOISOTOPES COBALT RADIOISOTOPES ENDOMETRIAL NEOPLASMS IRIDIUM RADIOISOTOPES NEOPLASM RECURRENCE, LOCAL NEOPLASM STAGING PROGNOSIS PROSPECTIVE STUDIES RADIOTHERAPY DOSAGE RISK FACTORS SURVIVAL RATE TREATMENT OUTCOME