Vol. 8 (02) pp. 1292-1300 DOI: 10.21474/IJAR01/10578

RADIATION THERAPY IN MANAGEMENT OF ENDOMETRIAL CARCINOMA: THE RESULTS OF A SINGLE INSTITUTION

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  • Mohammed VI University of Health Sciences (UM6SS). Casablanca, Morocco. Department of Radiotherapy, International University Hospital Sheikh Khalifa.
  • Mohammed V University In Rabat, Morocco. Department of Radiotherapy, National Institute of Oncology.
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Abstract

Purpose: We report the results of retrospective analysis of 50 cases of endometrial carcinoma treated by radiation therapy at the National Institute of Oncology of Rabat in Morocco. Materials and Methods: Between January 2011 and December 2012, all patients who has benefited from radiation therapy were retrieved. All patients were treated by conformational 3D radiotherapy. We analyzed clinical, histological characteristics, and treatment outcomes. Results: Median age of patients was 58 years. Main symptoms were metrorrhagia in 100% of cases, pelvic pain in 42 % of cases and vaginal discharge in 28%. The FIGO stages were respectively: IA 20 %, IB in 56%, II in 12%, IIIA in 4%, and IIIB in 2% and IIIC in 6 %. Histological grade was 1 in 30%, 2 in 48% and 3 in 22%. All patients underwent surgery. Adjuvant radiation therapy was delivered at a mean dose of 47 Gy (45-50, 4Gy). All patients were treated by conformational 3D radiotherapy. HDR brachytherapy was delivered in 65% of patients at a dose of 10 Gy (2x5Gy). The mean of total treatment duration was 50 days. The overall 5-year survival rate for our study was 90,1 %, and the overall local control rate was 69,6 %. Conclusions: The results of our study confirm that radiation therapy is a good option for treatment of endometrial carcinoma, and it is associated to good outcomes.

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References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015.CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29.
  2. Tazi M.A.,Erraki A.,BenjaafarN. Cancer incidence in Rabat, Morocco:2006-2008.Ecancermedicalscience.2013; 7: 338.
  3. Creasman WT, Odicino F, Maisonneuve P, Quinn MA, et al. Carcinoma of the corpus uteri.FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer.Int J Gynaecol Obstet. 2006 Nov;95Suppl 1:S105-43.
  4. ASTEC/EN.5 Study Group, Blake P, Swart AM, Orton J, Kitchener H, Whelan T, Lukka H, Eisenhauer E, Bacon M, Tu D, Parmar MK, Amos C, Murray C, Qian W. Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis. Lancet. 2009 Jan 10;373(9658):137-46.
  5. Practice Bulletin No. 149. : ?Endometrial cancer?.Obstetrics & Gynecology.2015,125(4):1006-1026.
  6. International Agency for Research on Cancer.World Cancer Report 2014:.Chapter 5.12.International Agency for Research on Cancer, 2014.
  7. Uharček P. Prognostic factors in endometrial carcinoma. J. Obstet.Gynaecol. Res., 2008,34, 776.
  8. Canlorbe G, Bendifallah S, Laas E, Raimond E, et al. Tumor Size, an AdditionalPrognostic Factor to Include in Low-RiskEndometrial Cancer: Results of a French MulticenterStudy. Ann SurgOncol. 2016 Jan;23(1):171-7.
  9. Kouhen F, Afif M, Benhmidou N, Rais F, et al. RADIATION THERAPY IN MANAGEMENT OF ENDOMETRIAL CARCINOMA: THE RESULTS OF A SINGLE INSTITUTION. AORTIC 2015. POSTER MP065Moroccan Poster Room.
  10. Colombo N, Preti E, Landoni F, Carinelli S, et al. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol (2011) 22 (suppl_6): vi35-vi39.
  11. Creasman W.T., Morrow C.P., Bundy B.N., Homesley H.D., Graham J.E., Heller P.B.:?Surgical pathologic spread patterns of endometrial cancer: A Gynecologic Oncology Group Study?. Cancer., 1987,60 (Supplement S8),2035.
  12. Kong A., Johnson N., Kitchener H.C. ?Adjuvant Radiotherapy for Stage I Endometrial Cancer: An Updated Cochrane Systematic Review and Meta-analysis?. JNCI J Natl Cancer Inst?,2012,djs374
  13. Aalders J., Abeler V., Kolstad P..?Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histopathologic study of 540 patients?. Obstetrics and gynecology.1980;56,419.
  14. Keys HM, Roberts JA, Brunetto VL, Zaino RJ, et al. A phase III trial of surgerywith or withoutadjunctiveexternalpelvic radiation therapy in intermediateriskendometrialadenocarcinoma: aGynecologicOncology Group study. GynecolOncol. 2004 Mar;92(3):744-51.
  15. Creutzberg CL, Nout RA, Lybeert ML, W?rl?m-Rodenhuis CC, et al. Fifteen-yearradiotherapyoutcomes of the randomized PORTEC-1 trial for endometrialcarcinoma. Int J RadiatOncolBiol Phys. 2011 Nov 15;81(4):e631-8.
  16. Soderini A., Anchezar J.P, Sardi J.E.?:?Role of adjuvant radiotherapy (RT) in intermediate risk (1b G2-3-1C) endometrioid carcinoma (EC) after extended staging surgery (ESS). Preliminary reports of a randomised trial.International.Journal.Of.Gynecological. Cancer,2003;13:78.
  17. Nout RA, Smit VT, Putter H, J?rgenliemk-Schulz IM, et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial.Lancet. 2010 Mar 6;375(9717):816-23.
  18. Sorbe B, Horvath G, Andersson H, Boman K, et al. External pelvic and vaginal irradiation versus vaginal irradiation alone as postoperative therapy in medium-risk endometrial carcinoma--a prospective randomized study. Int J RadiatOncolBiol Phys. 2012 Mar 1;82(3):1249-55.
  19. Mundt A.J, McBride R, Rotmensch J, Waggoner S.E, et al. Significant pelvic recurrence in high-risk pathologic stage I?IVendometrial carcinoma patients after adjuvant chemotherapy alone: implications for adjuvant radiation therapy. Int J RadiatOncolBiol Phys. 2001 Aug 1;50(5):1145-53.
  20. Klopp AH, Jhingran A, Ramondetta L, Lu K, Gershenson DM, Eifel PJ. Node-positive adenocarcinoma of the endometrium: outcome and patterns of recurrencewith and withoutexternalbeam irradiation. GynecolOncol. 2009 Oct;115(1):6-11.
  21. Hamilton C.A., Liu L., Osann K.N., Vasilev S. A., Berman M.L., Husain , et al.:Observation versus adjuvant treatment in early stage uterine serous carcinoma. International Journal of Gynecological Cancer, 2004; 14 : 17?18
  22. Paydar I, DeWees T, Powell M, Mutch DG, et al. Adjuvant radiotherapy in Stage II endometrial carcinoma: Is brachytherapy alone sufficient for local control? Brachytherapy. 2015 Jul-Aug;14(4):427-32.
  23. Hogberg T., Rosenberg P., Kristensen G., de Oliveira C.F.,de Pont Christensen R., Sorbe B., et al. :?A randomized phase-III study on adjuvant treatment with radiation (RT) ? chemotherapy (CT) in early-stage high-risk endometrial cancer (NSGO-EC-9501/EORTC 55991)?. J.Clin.Oncol. (Meeting Abstracts)., 2007 25(18_suppl), 5503.
  24. Randall ME1, Filiaci VL, Muss H, SpirtosNM,et al. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group Study. J ClinOncol. 2006 Jan 1;24(1):36-44.
  25. Susumu N, Sagae S, Udagawa Y, Niwa K, et al. Randomized phase III trial of pelvic radiotherapy versus cisplatin-based combined chemotherapy in patients with intermediate- and high-risk endometrial cancer: a Japanese Gynecologic Oncology Group study. GynecolOncol. 2008 Jan;108(1):226-33.
  26. Greven K, Winter K, Underhill K, Fontenesci J, et al. Final analysis of RTOG 9708: adjuvant postoperative irradiation combined with cisplatin/paclitaxel chemotherapy following surgery for patients with high-risk endometrial cancer. GynecolOncol. 2006 Oct;103(1):155-9.
  27. Meyer L.A., Bohlke K., Powell M.A., Fader A.N., Franklin G.E., Lee L.J.,et al.:?Postoperative Radiation Therapy for Endometrial Cancer:American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Evidence-Based Guideline?. JCO., 2015,33 ,2908.
  28. Hymel R, Jones GC, Simone CB.Wholepelvicintensity-modulatedradiotherapy for gynecologicalmalignancies: A review of the literature.CritRevOncolHematol. 2015 Jun;94(3):371-9.
  29. Beriwal S1, Jain SK, Heron DE, Kim H, et al. Clinical outcome with adjuvant treatment of endometrial carcinoma using intensity-modulated radiation therapy.GynecolOncol. 2006 Aug;102(2):195-9.
  30. Shih KK, Milgrom SA, Abu-Rustum NR, Kollmeier MA, et al. Postoperative pelvic intensity-modulated radiotherapy in high risk endometrial cancer.GynecolOncol. 2013 Mar;128(3):535-9.
  31. Jhingran A, Winter K, Portelance L, Miller B, et al. A phase II study of intensity modulated radiation therapy to the pelvis for postoperative patients with endometrial carcinoma: radiation therapy oncology group trial 0418. Int J RadiatOncolBiol Phys. 2012 Sep 1;84(1):e23-8.
  32. Barillot I, Tavernier E, Peignaux K, Williaume D, et al. Impact of post operativeintensitymodulatedradiotherapy on acute gastro-intestinal toxicity for patients withendometrial cancer: results of the phase II RTCMIENDOMETRE French multicentre trial. RadiotherOncol. 2014 Apr;111(1):138-43.
  33. Chen CC, Wang L, Lu CH, Lin JC, Jan JS. Comparison of clinicaloutcomes and toxicity in endometrial cancer patients treatedwith adjuvant intensity-modulated radiation therapy or conventionalradiotherapy. J Formos Med Assoc. 2014 Dec;113(12):949-55.

How to Cite This Article

F. Kouhen, M. Afif and N. Benjaafar (2020); RADIATION THERAPY IN MANAGEMENT OF ENDOMETRIAL CARCINOMA: THE RESULTS OF A SINGLE INSTITUTION, Int. J. of Adv. Res., 8 (02), 1292-1300, ISSN 2320-5407. DOI: https://doi.org/10.21474/IJAR01/10578

Corresponding Author

F. KOUHEN
Mohammed VI University of Health Sciences (UM6SS).
Creative Commons Attribution 4.0 This work is licensed under a Creative Commons Attribution 4.0 International License.