Relationship between interval from surgery to radiotherapy and local recurrence rate in patients with endometrioid-type endometrial cancer: a retrospective mono-institutional Italian study.
OBJECTIVE
To assess the relationship between the timing of radiotherapy and the risk of local failure in patients with endometrioid-type endometrial cancer who had undergone surgery and adjuvant external pelvic radiotherapy (with or without brachytherapy), but not chemotherapy.


METHODS
One hundred and seventy seven patients were analyzed in this study. The median follow-up of the survivors was 72 months.


RESULTS
Radiotherapy was delivered after a median time of 14.6 weeks from surgery and the median overall treatment time was 6.4 weeks. The tumor relapsed in 32 (18.1%) patients after a median time of 21 months. The local recurrence (vaginal or central pelvic) occurred in 11 patients. The local recurrence rate was associated with tumor grade (p=0.02), myometrial invasion (p=0.046), FIGO stage (p=0.003), pathological node status (p=0.037) and time interval from surgery to radiotherapy using 9 weeks as the cut-off value (p=0.046), but not with the overall treatment time. All the local relapses occurred in patients who received adjuvant irradiation after an interval from surgery >9 weeks.


CONCLUSIONS
The time interval from surgery to radiotherapy might affect the local recurrence rate in patients not receiving chemotherapy. Every possible effort should be made to start radiotherapy within 9 weeks, when radiotherapy only is deemed necessary as adjuvant treatment.
Department of Oncology, Division of Radiation Oncology, University of Pisa, Via Roma 56, Pisa, 56127, Italy. m.fabrini@ao-pisa.toscana.it
Maria Grazia
MG
Fabrini
Angiolo
A
Gadducci
Franco
F
Perrone
Concetta
C
La Liscia
Stefania
S
Cosio
Stefano
S
Moda
Maria Elena
ME
Guerrieri
Antonella
A
Grandinetti
Carlo
C
Greco
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007558:Italy; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome