title: Para-aortic and Pelvic Radiotherapy, an Effective and Safe Treatment in Advanced-stage Uterine Cancer.
abstract: OBJECTIVE
  The present, was a feasibility study of extended-field (EF) external-beam radiotherapy (EBRT) and vaginal brachytherapy (VBT) given sequentially following complete staging and adjuvant chemotherapy for patients with advanced-stage endometrial carcinoma (EC).
  
  
  METHODS
  A cohort study was carried out in 38 patients with stage IIIC and IVB EC treated by surgery, six cycles of paclitaxel-carboplatin chemotherapy followed by EF EBRT and VBT.
  
  
  RESULTS
  A total of 60% of the patients had non-endometrioid histology, 45% had both pelvic and para-aortic lymph node metastases. Two patients experienced recurrence in the previously irradiated field. Five-year overall and progression-free survival were 77% and 72.5%, respectively. Grade 1 diarrhea and grade 1 cystitis were the most common acute and delayed side-effects.
  
  
  CONCLUSIONS
  EF EBRT and VBT following complete staging and adjuvant chemotherapy is a safe and effective treatment for patients with advanced-stage EC. Compared to historical data, our study suggests an improved progression-free and overall survival with acceptable acute and delayed side-effects.
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Quebec, Canada drrabino@bgu.ac.il.
authors.forename: Alex
authors.initials: A
authors.lastname: Rabinovich
authors.affiliation: Division of Radiation Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Laurence
authors.initials: L
authors.lastname: Bernard
authors.affiliation: Division of Radiation Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Tamim M
authors.initials: TM
authors.lastname: Niazi
authors.affiliation: Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.
authors.forename: Agnihotram V
authors.initials: AV
authors.lastname: Ramanakumar
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Walter H
authors.initials: WH
authors.lastname: Gotlieb
authors.affiliation: Division of Gynecologic Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Susie
authors.initials: S
authors.lastname: Lau
authors.affiliation: Division of Radiation Oncology, Segal Cancer Center, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Boris
authors.initials: B
authors.lastname: Bahoric
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology / Q000528:radiation effects; D001918:Brachytherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010388:Pelvis / Q000473:pathology / Q000528:radiation effects; D014594:Uterine Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*
keywords: Advanced-stage endometrial cancer; extended-field external-beam radiotherapy; intensity-modulated radiotherapy