title: Adjuvant Chemotherapy and Vaginal Vault Brachytherapy With or Without Pelvic Radiotherapy for Stage 1 Papillary Serous or Clear Cell Endometrial Cancer.
abstract: OBJECTIVE
  The aim of this study was to assess and compare adjuvant chemotherapy followed by either high-dose-rate vaginal vault brachytherapy (VBT) alone or combined with pelvic external beam radiotherapy (EBRT) for International Federation of Gynaecology and Obstetrics stage 1 serous or clear cell (CC) endometrial cancer.
  
  
  METHODS
  Between 2006 and 2012, 84 women with stage 1 serous or CC endometrial cancer were evaluated postoperatively for adjuvant treatment at our hospital. More than 80% of patients had pelvic lymphadenectomy. Patients declining or not completing adjuvant treatments were excluded. Twenty-five women received 4 to 6 cycles of carboplatin/paclitaxel followed by EBRT and VBT. Thirty-two women received 6 cycles of carboplatin/paclitaxel followed by VBT. Locoregional control and toxicities were assessed during follow-up.
  
  
  RESULTS
  The 3-year disease-free survival and overall survival rates for the VBT group compared with the EBRT + VBT group were 88% versus 84%, P = 0.6, and 100% versus 94%, P = 0.6, respectively. Only 1 patient in the EBRT + VBT group developed a distant recurrence. One patient had grade 3 toxicity (chronic gastrointestinal [GI] toxicity) in the EBRT + VBT group. Acute grade 1-to-2 GI and grade 1 genitourinary (GU) toxicities were less frequent in the VBT group compared with the EBRT + VBT group (P = 0.008 and P = 0.019, respectively). Late GI and GU toxicities were comparable. Grade 1 vaginal toxicity was similar in both groups. No acute or late grade 2 GU or vaginal toxicities were reported.
  
  
  CONCLUSIONS
  According to this study, VBT alone seems to be as effective as EBRT and VBT for stage 1 serous and CC endometrial cancer treated with surgery and adjuvant chemotherapy. Furthermore, less acute GI and GU toxicities were seen in the VBT group.
authors.affiliation: *Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montréal; †Department of Radiation Oncology, Centre de Santé et de Services Sociaux Champlain-Charles Le Moyne, Longueuil; and ‡Department of Gynecology Oncology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Tétreault-Laflamme
authors.forename: Thu Van
authors.initials: TV
authors.lastname: Nguyen-Huynh
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Carrier
authors.forename: Vanessa
authors.initials: V
authors.lastname: Samouëlian
authors.forename: Philippe
authors.initials: P
authors.lastname: Sauthier
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Beauchemin
authors.forename: Maroie
authors.initials: M
authors.lastname: Barkati
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000706:statistics & numerical data*; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies