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The efficacy of postoperative vaginal irradiation in preventing vaginal recurrence in endometrial cancer
  1. P. Elliott,
  2. D. Green,
  3. A. Coates,
  4. M. Krieger,
  5. P. Russell,
  6. M. Coppleson,
  7. J. Solomon and
  8. M. Tattersall
  1. Department of Gynaecological Oncology, King George Vth (Royal Prince Alfred) Hospital, Camperdown, Australia
  1. Address for correspondence: Peter Elliott, Head, Department of Gynaecological Oncology, King George Vth Hospital, Missenden Road, Camperdown, 2050, Australia.


Between 1960 and 1985 hysterectomy was performed on 811 FIGO stage I and 116 stage II endometrial cancers which were divided into three groups: low-risk stage Ii (grade 1 and 2 lesions confined to the inner third of the myometrium; high-risk stage Iii (grade 3 and/or invading to the middle third of the myometrium or beyond); and FIGO stage II tumors (also high-risk). Hysterectomy was the only treatment in 492; in 145 the vaginal vault alone was radiated and in 290 the whole vagina, in each instance by an intracavity dose of 60Gy; in 34 of the latter high-risk tumors the pelvis received an additional 46Gy by external beam therapy. Forty isolated vaginal recurrences were detected; 10 in 308 low-risk and 22 in 184 high-risk tumors treated by surgery alone, and two and five in 40 low and 105 high-risk patients, respectively, who received adjuvant vault irradiation. No recurrences followed irradiation of the whole vaginal mucosa in 163 stage Ii low-risk and 40 stage II lesions and one, 9 years later, in 87 high-risk stage Iii tumors. Nearly 45% of patients with vaginal recurrence died from cancer within 1 year, 77% within 5 years and only 10% survived their recurrence 10 years. Total vaginal irradiation eliminated vaginal recurrences in low risk and reduced the incidence to 2.1% at 20 years after high-risk tumors.

  • endometrial cancer
  • prevention
  • vaginal recurrence.

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