Kucera H, Knocke T H, Kucera E, Pötter R
Department of Gynecology, University of Vienna, Medical School, Austria.
Acta Obstet Gynecol Scand. 1998 Nov;77(10):1008-12.
To review the results of treatment with high-dose-rate brachytherapy alone in 228 patients with stage I endometrial carcinoma who are unfit for surgery.
All patients received an exclusive radiation therapy by means of high-dose-rate Iridium 192 intracavitary brachytherapy without additional external beam radiation.
At 5 years, the overall survival rate was 59.7% and disease specific survival 85.4% at 10 years 30.2% and 75.1%. In clinical stage Ia disease specific survival was 88.6% at 5 years and 82.7% at 10 years, in stage Ib 80.2% and 63.4%, respectively (p<0.02). Disease specific survival was not affected by tumor grade or age. The rates of local control are related to the size of the uterus but not to the tumor grading. Intrauterine recurrence occurred in 17.5% but extrauterine pelvic relapse in only 0.4% of patients. The calculated probability of severe complications was 4.6% at 5 years.
HDR brachytherapy alone achieves excellent disease specific survival rates in patients with medically inoperable stage I endometrial carcinoma.
回顾228例不宜手术的I期子宫内膜癌患者单纯高剂量率近距离放射治疗的结果。
所有患者均接受单纯高剂量率铱192腔内近距离放射治疗，未附加外照射。
5年时，总生存率为59.7%；10年时，疾病特异性生存率为85.4%，分别为30.2%和75.1%。在临床Ia期，疾病特异性生存率5年时为88.6%，10年时为82.7%；在Ib期分别为80.2%和63.4%（p<0.02）。疾病特异性生存率不受肿瘤分级或年龄影响。局部控制率与子宫大小有关，但与肿瘤分级无关。17.5%的患者发生子宫内复发，而子宫外盆腔复发仅占0.4%。5年时严重并发症的计算概率为4.6%。
对于医学上不宜手术的I期子宫内膜癌患者，单纯高剂量率近距离放射治疗可实现优异的疾病特异性生存率。
