RADIATION AND CHEMORADIATION THERAPY FOR I STAGE INTERMEDIATE AND HIGH/INTERMEDIATE ENDOMETRIAL CANCER - DESCRIPTIVE ANALYSIS

Probl Radiac Med Radiobiol. 2021 Dec:26:554-561. doi: 10.33145/2304-8336-2021-26-554-561.
[Article in English, Ukrainian]

Abstract

Introduction: Endometrial cancer ranks the third place in prevalence among all cancers in Ukraine. The surgicaltreatment and subsequent adjuvant treatment is planned according to the patient's risk group. The choice of radi-ation therapy and the need to add chemotherapy determines the level of recurrence-free survival.

Objective: The aim of the study was to analyze the database of treated patients in National Cancer Institute, with Istage endometrial cancer intermediate and high-intermediate group; determination of the most frequent choice ofradiation treatment in accordance with the risk group of patients with a hysterectomy with salpingo-oophorectomyfor further observation and evaluation of diseasefree survival.

Materials and methods: Retrospective was analysed 245 patients with high and intermediate risk groups with stageI endometrial cancer. The exclusion criteria were: low-risk patients, stages II-IV and non-endometrioid histologi-cal variant.

Results: According to the analysis, there were 122/245 (49.8 %) patients of high risk group, 123/245 (50.2 %) ofintermediate risk group. High-risk patients underwent external beam therapy and brychytherapy, supplemented bychemotherapy in 5.8 % of cases (7 patients), brachytherapy with external beam therapy was performed in 58.2 % ofcases (71 patients), brachytherapy - in 8.1 % of cases (10 patients), external beam therapy was performed in 27.9 %cases. Intermediate and high-intermediate risk patients were distributed as follows: brachytherapy was performedin 41.5 % of cases (51 patients), brachytherapy with external beam therapy - 54.5 % (67 patients), external beamtherapy was performed in 5 patients.

Conclusion: Brachytherapy is available for patients with intermediate risk endometrial cancer and external beamtherapy with possible addition of brachytherapy is recommended for high-intermediate and high-risk groups, espe-cially in patients with lymphatic vascular involvement. All patients are monitored for further assessment of recur-rence-free survival.

Vstup. Rak endometriia zaĭmaie tretie mistse za rozpovsiudzhenistiu sered vsikh onkologichnykh zakhvoriuvan' v Uk-raïni. Ob’iem khirurgichnogo likuvannia ta podal'she ad’iuvantne likuvannia planuiet'sia vidpovidno do grupy ryzy-ku patsiientky. Vybir metodu promenevogo likuvannia i neobkhidnist' dodavannia khimioterapiï vyznachaie riven'bezretsydyvnoï vyzhyvanosti.Meta doslidzhennia: provedennia analizu bazy danykh Natsional'nogo instytutu raku prolikovanykh patsiientok zendometrioïdnym RE I stadiï promizhnoï ta vysoko-promizhnoï grup, a takozh vyznachennia naĭbil'sh chastogo vy-boru ad’iuvantnogo (promenevogo/khimiopromenevogo) likuvannia vidpovidno do grupy ryzyku patsiientok, iakymbula provedena gisterektomiia z dvobichnoiu sal'pingo-ovarektomiieiu dlia podal'shogo sposterezhennia ta otsinkybezretsydyvnoï vyzhyvanosti.Materialy ta metody. Retrospektyvno provedeno analiz 245 patsiientok, vysokoï ta promizhnoï grup ryzyku zI stadiieiu raku endometriia. Kryteriiamy vykliuchennia staly patsiientky nyz'koï grupy ryzyku, a takozh zi stadiiamyII–IV i neendometrioïdnym gistologichnym variantom. Rezul'taty. Vidpovidno do provedenogo analizu, patsiientok vysokoï grupy ryzyku bulo 122/245 (49,8 %),promizhnoï grupy ryzyku – 123/245 (50,2 %). Patsiientkam vysokoï grupy ryzyku bulo provedeno dystantsiĭnupromenevu i brakhiterapiiu, dopovniuiuchy khimioterapiieiu u 5,8 % vypadkiv (7 patsiientok), brakhiterapiiu z dys-tantsiĭnoiu promenevoiu terapiieiu – u 58,2 % vypadkiv (71 patsiientka), brakhiterapiiu – u 8,1 % vypadkiv (10patsiientok), dystantsiĭnu promenevu terapiiu – u 27,9 % vypadkiv (34 patsiientky). Patsiientky promizhnogo ta vy-soko-promizhnogo ryzyku rozpodilylys' takym chynom: brakhiterapiia bula provedena u 41,5 % vypadkiv (51patsiientka), brakhiterapiia z dystantsiĭnoiu promenevoiu terapiieiu – 54,5 % (67 patsiientok), dystantsiĭna prome-neva terapiia – 4,1 % (5 patsiientok).Vysnovok. Otzhe, dlia patsiientok z rakom endometriia promizhnoï grupy ryzyku zgidno z osnovnymy provedeny-my prospektyvnymy doslidzhenniamy ratsional'nym ie provedennia brakhiterapiï, a dlia vysoko-promizhnoï i vyso-koï grupy ryzyku rekomendovano dystantsiĭnu promenevu terapiiu z mozhlyvym dodavanniam brakhiterapiï, osob-lyvo u patsiientok iz zaluchenniam limfovaskuliarnogo prostoru. Vsi patsiientky perebuvaiut' pid sposterezhenniamdlia podal'shoï otsinky bezretsydyvnoï vyzhyvanosti.

Keywords: chemo and radiotherapy; endometrial cancer; external beam therapy; lymphadenectomy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use*
  • Chemoradiotherapy / methods*
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / epidemiology
  • Endometrial Neoplasms / radiotherapy*
  • Endometrial Neoplasms / surgery*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control*
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Ukraine / epidemiology
  • Young Adult

Substances

  • Antineoplastic Agents