Lancellotta Valentina, De Felice Francesca, Vicenzi Lisa, Antonacci Alfredo, Cerboneschi Valentina, Costantini Sara, di Cristino Daniela, Tagliaferri Luca, Cerrotta Annamaria, Vavassori Andrea, Gribaudo Sergio, Colombo Alessandro, Lucà Francesco, Barbara Raffaele, Mangoni Monica, Marampon Francesco, Musio Daniela, Bellati Filippo, Torcia Francesco, Tombolini Vincenzo, Osti Mattia Falchetto, De Sanctis Vitaliana
Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia - Gemelli ART (Advanced Radiation Therapy), Interventional Oncology Center (IOC), Roma, Italy.
Department of Radiological, Oncological and Anatomo Pathological Sciences, Azienda Ospedaliero Universitaria Policlinico Umberto I, "Sapienza" University, Rome, Italy.
J Contemp Brachytherapy. 2020 Feb;12(1):61-66. doi: 10.5114/jcb.2020.92698. Epub 2020 Feb 28.
Serous adenocarcinoma (uterine serous carcinoma - USC) is a rare and aggressive histologic subtype of endometrial cancer, with a high-rate of recurrence and poor prognosis. The adjuvant treatment for stage I patients is unclear. The purpose of this study was to evaluate the outcomes of stage I USC treated exclusively with chemotherapy plus vaginal brachytherapy (VBT).
A systematic research using PubMed, Scopus, and Cochrane library was conducted to identify full articles evaluating the efficacy of VBT in patients with stage I USC. A search in ClinicalTrials.gov was performed in order to detect ongoing or recently completed trials, and in PROSPERO for searching ongoing or recently completed systematic reviews.
All studies were retrospective and 364 of evaluated patients were found. The average local control was 97.5% (range, 91-100%), the disease free-survival was 88% (range, 82-94%), the overall survival was 93% (range, 72-100%), the specific cancer survival was 89.4% (range, 84.8-94%), and the G3-G4 toxicity was 0-8%.
These data support the concept that in adequately selected patients, VBT alone may be a suitable radiotherapy technique in women with stage I USC who underwent surgical staging and received adjuvant chemotherapy.
浆液性腺癌（子宫浆液性癌-USC）是子宫内膜癌中一种罕见且侵袭性强的组织学亚型，复发率高且预后较差。I期患者的辅助治疗尚不清楚。本研究的目的是评估单纯化疗加阴道近距离放疗（VBT）治疗I期USC的疗效。
利用PubMed、Scopus和Cochrane图书馆进行系统研究，以确定评估VBT对I期USC患者疗效的完整文章。在ClinicalTrials.gov上进行检索，以检测正在进行或最近完成的试验，并在PROSPERO上检索正在进行或最近完成的系统评价。
所有研究均为回顾性研究，共纳入364例评估患者。平均局部控制率为97.5%（范围91%-100%），无病生存率为88%（范围82%-94%），总生存率为93%（范围72%-100%），特定癌症生存率为89.4%（范围84.8%-94%），3-4级毒性为0%-8%。
这些数据支持这样的观点，即在适当选择的患者中，对于接受手术分期并接受辅助化疗的I期USC女性，单纯VBT可能是一种合适的放疗技术。
