Latini P, Giannone E
Unità Organica di Radioterapia Oncologica, Policlinico di Perugia.
Minerva Ginecol. 1990 Jan-Feb;42(1-2):1-5.
From 1977 to 1985 160 endometrial carcinoma stage I patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy and postoperative irradiation. Hundred-thirty-one patients received postoperative pelvic telecobalt-therapy, total dose 45-50 Gy and 29 patients received postoperative endocavitary curietherapy (Cs137) to the vagina vault, total dose 50 Gy. Median follow-up was 5.6 years (range 3-11 years). Overall actuarial five-years disease-free survival was 89% +/- 2.7. For the group of patients treated with external radiotherapy and group receiving curietherapy 5-years D.F. survival was respectively 88% +/- 2.9 83% +/- 4.7. There is no statistically significant difference in survival time between the two groups (p = 0.688). There were no cases of vaginal recurrence (0%) and 2/160 cases (1.2%) there pelvic relapse. In 2/160 cases (1.2%) distant metastases occurred. Late I II grade effects were found in 15/160 cases (9.3%). Retrospective analysis of results and casuistry lead to the conclusion that radiotherapy must, in cases at risk, follow surgery in the treatment of stage I endometrial carcinoma with the aim of reducing the loco-regional relapses and increasing survival time.
1977年至1985年期间,160例I期子宫内膜癌患者接受了全腹子宫切除术、双侧输卵管卵巢切除术及术后放疗。131例患者接受了术后盆腔钴远距离治疗,总剂量为45 - 50 Gy,29例患者接受了阴道穹窿腔内镭疗(铯137),总剂量为50 Gy。中位随访时间为5.6年(范围3 - 11年)。总体精算5年无病生存率为89%±2.7。接受外照射放疗组和接受镭疗组的5年无病生存率分别为88%±2.9和83%±4.7。两组患者的生存时间无统计学显著差异(p = 0.688)。无阴道复发病例(0%),盆腔复发2/160例(1.2%)。远处转移2/160例(1.2%)。15/160例(9.3%)出现晚期I、II级效应。对结果和病例的回顾性分析得出结论,对于有风险的病例,放疗必须在I期子宫内膜癌的治疗中在手术之后进行,以减少局部区域复发并延长生存时间。