title: External-beam radiotherapy and/or HDR brachytherapy in postoperative endometrial cancer patients: clinical outcomes and toxicity rates.
abstract: OBJECTIVE
  The objectives of this study were to evaluate local disease control, overall survival (OS), disease-free survival (DFS) and local relapse-free survival (LRFS) in patients with endometrial cancer undergoing adjuvant vaginal brachytherapy (VBT )± external-beam radiotherapy (EBRT).
  
  
  METHODS
  From September 2007 to February 2011, 40 patients with endometrial cancer were retrospectively analysed. Surgery consisted of total hysterectomy and bilateral salpingo-oophorectomy without node dissection (16 patients) or with bilateral pelvic node dissection (24 patients). The stage distribution was as follows: two IA, nine IB, 12 IC, five IIA, eight IIB, two IIIA and two IIIC. Thirty-four patients underwent EBRT and VBT. Six patients received VBT alone.
  
  
  RESULTS
  Median follow-up was 26 months. The 5-year OS and DFS were 96.4% and 86.9%, respectively. No local recurrence was observed. Four patients presented distant disease (three had lung metastases and one had hepatic node metastases). Acute EBRT-related toxicities were seen in 15 (38%) patients. We recorded late toxicities in 14 patients (35%). There was no evidence of grade 3-4 toxicity.
  
  
  CONCLUSIONS
  Adjuvant EBRT and/or VBT in patients with endometrial cancer showed good outcomes in terms of local disease control, with an acceptable toxicity profile.
authors.affiliation: Institute of Radiation Oncology, University La Sapienza, Ospedale S. Andrea, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: De Sanctis
authors.forename: L
authors.initials: L
authors.lastname: Agolli
authors.forename: M
authors.initials: M
authors.lastname: Valeriani
authors.forename: S
authors.initials: S
authors.lastname: Narici
authors.forename: M F
authors.initials: MF
authors.lastname: Osti
authors.forename: F
authors.initials: F
authors.lastname: Patacchiola
authors.forename: B
authors.initials: B
authors.lastname: Mossa
authors.forename: M
authors.initials: M
authors.lastname: Moscarini
authors.forename: R
authors.initials: R
authors.lastname: Maurizi Enrici
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D016889:Endometrial Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010052:Ovariectomy; D016016:Proportional Hazards Models; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D058994:Salpingectomy; D015996:Survival Rate; D016896:Treatment Outcome