Sears J D, Greven K M, Hoen H M, Randall M E
Department of Radiology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina 27157.
Cancer. 1994 Aug 15;74(4):1303-8. doi: 10.1002/1097-0142(19940815)74:4<1303::aid-cncr2820740420>3.0.co;2-g.
Women who do not receive adjuvant irradiation after hysterectomy for endometrial carcinoma (EC) are at risk for developing a pelvic recurrence. Disease- and treatment-related factors were examined for their impact on disease-specific survival (DSS) and pelvic control (PC) in patients with locoregional recurrences to whom salvage radiotherapy was administered.
Forty-five patients with pelvic/vaginal recurrences of EC were treated at a single institution between 1973 and 1991. The median follow-up period was 89 months. Multiple patient-, disease-, and treatment-related factors were examined with univariate and multivariate analysis for their impact on DSS and PC. Kaplan-Meier methods were used to estimate outcomes.
Overall DSS and PC was 51 and 54% at 5 years, respectively. Univariate analysis revealed the following factors to impact on outcome (P < or = 0.05): age (DSS, PC), vaginal stage of recurrence (DSS, PC), size of recurrence (DSS, PC), time interval from hysterectomy (DSS, PC), initial grade (DSS), location of recurrence (PC), and radiation boost technique (PC).
Women in whom endometrial cancer recurrences develop can be salvaged with aggressive radiotherapy consisting of external beam therapy followed by a radiation boost. Close follow-up after the initial hysterectomy is important because patients with low-volume recurrence limited to the vagina have the best outcome.
子宫内膜癌（EC）患者子宫切除术后未接受辅助放疗有盆腔复发风险。本研究探讨疾病及治疗相关因素对接受挽救性放疗的局部区域复发患者疾病特异性生存（DSS）和盆腔控制（PC）的影响。
1973年至1991年间，一家机构共治疗了45例EC盆腔/阴道复发患者。中位随访期为89个月。采用单因素和多因素分析，研究多种患者、疾病和治疗相关因素对DSS和PC的影响。采用Kaplan-Meier方法评估预后。
5年时总体DSS和PC分别为51%和54%。单因素分析显示以下因素对预后有影响（P≤0.05）：年龄（DSS、PC）、复发的阴道分期（DSS、PC）、复发大小（DSS、PC）、子宫切除术后时间间隔（DSS、PC）、初始分级（DSS）、复发部位（PC）和放疗增敏技术（PC）。
子宫内膜癌复发的女性患者可通过外照射后加量的积极放疗挽救。初次子宫切除术后密切随访很重要，因为复发灶小且局限于阴道的患者预后最佳。
