Rush S, Gal D, Potters L, Bosworth J, Lovecchio J
Long Island Radiation Therapy, Manhasset, NY 11030, USA.
Int J Radiat Oncol Biol Phys. 1995 Nov 1;33(4):851-4. doi: 10.1016/0360-3016(95)02012-8.
To determine if postoperative external pelvic radiation (EBRT), without vaginal brachytherapy, is sufficient to prevent vaginal cuff and pelvic recurrences in patients with surgical Stage I endometrial adenocarcinoma (ACA).
The records of 122 patients with surgical Stage I endometrial cancer were reviewed. There were 87 patients with ACA who received EBRT alone and are the subject of this study. Their radiation records were reviewed. All patients underwent exploration, total abdominal hysterectomy, and bilateral salpingo-oophorectomy (TAH BSO), and pelvic and paraaortic lymph node sampling. They were staged according to the FIGO 1988 surgical staging system recommendations. Postoperatively, pelvic EBRT was administered by megavoltage equipment using four fields, to a total dose of 45 to 50.4 Gy. Actuarial survival and disease free survival were calculated according to Kaplan-Meier Method.
Twenty-seven patients with Stage IA Grade 1 or 2 ACA with less than one-third myometrial invasion, who did not receive EBRT, and eight patients with histology other than adenocarcinoma (i.e., serous papillary, mucinous, etc.) were not included in the study. For the remaining 87 patients who are in the study group, the median follow-up was 52 months (range: 12-82 months). The 5-year overall survival for these 87 patients was 92%, with a disease-free survival of 83%. There were no tumor recurrences in the upper vagina or in the pelvis. Two patients developed small bowel obstruction (no surgery required), and one patient developed chronic enteritis.
Adjuvant external pelvic radiation, without vaginal brachytherapy, prevents pelvic and vaginal cuff recurrences in surgical Stage I endometrial ACA.
确定在不进行阴道近距离放疗的情况下，术后盆腔外照射放疗（EBRT）是否足以预防手术分期为I期的子宫内膜腺癌（ACA）患者的阴道残端和盆腔复发。
回顾了122例手术分期为I期的子宫内膜癌患者的记录。本研究纳入了87例仅接受EBRT的ACA患者。对他们的放疗记录进行了回顾。所有患者均接受了探查、全腹子宫切除术和双侧输卵管卵巢切除术（TAH BSO），以及盆腔和腹主动脉旁淋巴结取样。根据1988年国际妇产科联盟（FIGO）手术分期系统建议进行分期。术后，使用兆伏级设备通过四个野进行盆腔EBRT，总剂量为45至50.4 Gy。根据Kaplan-Meier方法计算精算生存率和无病生存率。
27例IA期1级或2级、肌层浸润小于三分之一且未接受EBRT的ACA患者，以及8例组织学类型为非腺癌（即浆液性乳头状癌、黏液性癌等）的患者未纳入本研究。对于研究组中其余的87例患者，中位随访时间为52个月（范围：12 - 82个月）。这87例患者的5年总生存率为92%，无病生存率为83%。上阴道或盆腔均未出现肿瘤复发。2例患者发生小肠梗阻（无需手术），1例患者发生慢性肠炎。
在不进行阴道近距离放疗的情况下，辅助盆腔外照射放疗可预防手术分期为I期的子宫内膜ACA患者的盆腔和阴道残端复发。
