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Brachytherapy. 2018 Jan - Feb;17(1):194-200. doi: 10.1016/j.brachy.2017.09.011.

Impact of radiotherapy modalities on outcomes in the adjuvant management of uterine carcinosarcoma: A National Cancer Database analysis.

Author information

1
Department of Radiation Oncology, University of Colorado Denver, Aurora, CO. Electronic address: william.stokes@ucdenver.edu.
2
Department of Radiation Oncology, University of Colorado Denver, Aurora, CO.

Abstract

PURPOSE:

In the postoperative management of uterine carcinosarcoma (UCS), the roles of individual radiotherapy (RT) modalities, chiefly external-beam radiotherapy (EBRT) and brachytherapy (BT), remain undefined. We analyzed the survival impact of EBRT and BT using the National Cancer Database.

METHODS AND MATERIALS:

We abstracted women diagnosed with UCS from 2004 to 2012 who received hysterectomy and had complete RT information. Cox multivariate analysis and propensity-score matched analyses were used to compare survival among radiotherapeutic approaches.

RESULTS:

We identified 1229 women receiving no radiotherapy, 472 receiving EBRT alone, 331 receiving BT alone, and 271 receiving EBRT+BT. On multivariate analysis of the entire analytic cohort, survival was significantly improved among patients receiving EBRT+BT combination (hazard ratio [HR] 0.72, 95% confidence interval [CI] = 0.58-0.89, p < 0.01), but not among those receiving EBRT alone (HR 0.93, 95% CI = 0.79-1.10, p = 0.41) or BT alone (HR 0.84, 95% CI = 0.68-1.03, p = 0.09). These results were confirmed on propensity-score matches for EBRT vs. no RT (HR 0.89, 95% CI = 0.73-1.07, p = 0.34), BT vs. no RT (HR 0.80, 95% CI = 0.63-1.03, p = 0.09), and EBRT+BT vs. no RT (HR 0.74, 95% CI = 0.58-0.96, p = 0.02).

CONCLUSIONS:

EBRT+BT combination is associated with an overall survival advantage in UCS and warrants consideration in the adjuvant management of this disease.

KEYWORDS:

Brachytherapy; Carcinosarcoma; External-beam radiotherapy; Radiation therapy; Uterine cancer

PMID:
29097136
DOI:
10.1016/j.brachy.2017.09.011
[Indexed for MEDLINE]

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