Long term outcomes of patients with endometrial carcinoma treated with radiation - Siriraj Hospital experience.
BACKGROUND
To evaluate treatment outcomes of patients with stage I-III endometrial cancer treated with postoperative radiation.


METHODS
A retrospective review of 166 endometrial cancer patients, undergoing surgery and postoperative radiotherapy at Siriraj Hospital from 2005-2008 was performed. Pathology was reviewed. Results of treatment were reported with 5-year loco-regional recurrence free survival (LRRFS), 5-year overall survival (OS), patterns of failure and toxicity, and according to stage and risk groups.


RESULTS
Median follow up time was 62.8 months. Pathological changes were found in 36.3% of the patients after central reviews, leading to 19% changes in risk groups. Most of the patients (83.7%) received pelvic radiation (PRT) and vaginal brachytherapy (VBT). Five-year LRRFS and OS of all patients were 94.9% and 85.5%, respectively. There was no recurrence or death in low and low-intermediate risk groups. For the high-intermediate risk group, 5-year LRRFS and OS were 96.2% and 90.8%, respectively, and for the high risk group 90.5% and 71%. Late grade 3 and 5 gastrointestinal toxicity was found in 3% and 1.2% of patients, respectively. All of them received PRT 5,000 cGy in 25 fractions.


CONCLUSIONS
Low and intermediate risk patients had good results with surgery and adjuvant radiation therapy. For high risk patients, postoperative radiation therapy alone appeared to be inadequate as the most common pattern of failure was distant metastasis.
Division of Radiation Oncology, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand E-mail : janjira.pet@mahidol.ac.th.
Jiraporn
J
Setakornnukul
Janjira
J
Petsuksiri
Sirentra
S
Wanglikitkoon
Malee
M
Warnnissorn
Kullathorn
K
Thephamongkhol
Yaowalak
Y
Chansilp
Vutisiri
V
Veerasarn
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome