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Gynecol Oncol. 2004 Aug;94(2):383-6.

High-dose rate brachytherapy for Stage I/II papillary serous or clear cell endometrial cancer.

Author information

  • 1Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Wilmot Cancer Center, University of Rochester School of Medicine, 125 Lattimore Road, Rochester, NY 14620, USA. Brent_DuBeshter@urmc.rochester.edu

Abstract

OBJECTIVE:

To determine the efficacy of high-dose rate brachytherapy as adjuvant treatment for Stage I/II papillary serous or clear cell endometrial cancer.

METHODS:

A retrospective study of all patients with Stage I/II papillary serous or clear cell endometrial cancer treated with high-dose rate brachytherapy between 1995 and 2001 was performed. Following surgical staging, which included hysterectomy with pelvic and aortic lymphadenectomy, all patients without extrauterine disease were treated with high-dose rate brachytherapy and followed for recurrence. The locations of recurrences were noted and were classified as local or distant.

RESULTS:

Three (13%) recurrences occurred among 24 patients with Stage I/II papillary serous or clear cell carcinoma. The risk of recurrence was similar for papillary serous and clear cell cancer (12% vs. 12%). Local control was achieved in 96%. The risk of recurrence for those with no myometrial invasion, less than 1/2, or more than 1/2 myometrial invasion was 0%, 10%, and 50%, respectively (P < 0.04). Two of the three recurrences were distant and all patients with recurrence died despite additional treatment.

CONCLUSIONS:

High-dose rate brachytherapy (HDR) as the sole adjuvant treatment of Stage I/II papillary serous or clear cell carcinoma is associated with a 13% risk of recurrence. Although local control with HDR is excellent, the risk of distant recurrence is increased with deep myometrial invasion. High-dose rate brachytherapy is adequate for Stage IA cases, but more aggressive treatment combining chemotherapy with HDR should be evaluated for more advanced Stage I/II cases.

PMID:
15297176
[PubMed - indexed for MEDLINE]
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