title: Patterns of care in women with high-intermediate risk endometrioid adenocarcinoma in the PORTEC-2 era: A SEER database analysis.
abstract: We examined the radiotherapy patterns of care over an 8-year period during which the PORTEC-2 trial and other series were published.
  
  
  
  Patients diagnosed with Stage I endometrioid adenocarcinoma (EA) between 2004 and 2011 were identified in the National Cancer Institute's Surveillance, Epidemiology, and End Results database. Adjuvant radiation treatments were analyzed by year. Patterns of care from 2004 to 2008 were compared to those from 2009 to 2011 using the χ2test.
  
  
  
  Analysis included 31,688 patients with Stage I EA. Among those diagnosed in 2004, 9.3% received adjuvant external beam radiotherapy (EBRT) and 5.0% received adjuvant brachytherapy. In 2011, 4.5% received EBRT and 9.3% received brachytherapy. In those diagnosed with high-intermediate risk (H-IR) EA in 2004, 58.8% received no adjuvant treatment, 28.3% received EBRT, and 12.9% received brachytherapy. In 2011, 57.8% of patients with H-IR disease received no adjuvant treatment, 14.3% received EBRT, and 27.9% received brachytherapy. There was a significant difference in the proportion of patients with H-IR EA treated with EBRT vs. brachytherapy alone before and after 2008 (p < 0.0001) with an increase in use of brachytherapy and a decrease in the use of EBRT.
  
  
  
  The use of brachytherapy alone after hysterectomy has increased over time in all women with Stage I EA and in those with H-IR disease. In almost all subsets, the proportion of women being treated with brachytherapy increased and the proportion treated with EBRT decreased. Less than 30% received adjuvant brachytherapy and over 50% of women were treated without adjuvant radiotherapy.
authors: Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI; Department of Radiation Oncology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA. Electronic address: Peter.zavitsanos@lifespan.org.
authors: Peter J
authors: PJ
authors: Zavitsanos
authors: Department of Radiation Oncology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI. Electronic address: Kleonard2@lifespan.org.
authors: Kara L
authors: KL
authors: Leonard
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods* / Q000639:trends; D018269:Carcinoma, Endometrioid / Q000473:pathology / Q000532:radiotherapy*; D016208:Databases, Factual; D016889:Endometrial Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians' / Q000639:trends; D018714:Radiotherapy, Adjuvant / Q000379:methods / Q000639:trends; D012189:Retrospective Studies; D018426:SEER Program; D014481:United States; D055815:Young Adult
keywords: Brachytherapy; Carcinoma endometrium; PORTEC; Radiation therapy; Treatment patterns