Long Term Outcomes of Patients with Endometrial Carcinoma Treated with Radiation - Siriraj Hospital Experience


Background: To evaluate treatment outcomes of patients with stage I-III endometrial cancer treated withpostoperative radiation. Materials and
Methods: A retrospective review of 166 endometrial cancer patients,undergoing surgery and postoperative radiotherapy at Siriraj Hospital from 2005-2008 was performed. Pathologywas reviewed. Results of treatment were reported with 5-year loco-regional recurrence free survival (LRRFS),5-year overall survival (OS), patterns of failure and toxicity, and according to stage and risk groups.
Results:Median follow up time was 62.8 months. Pathological changes were found in 36.3% of the patients after centralreviews, leading to 19% changes in risk groups. Most of the patients (83.7%) received pelvic radiation (PRT)and vaginal brachytherapy (VBT). Five-year LRRFS and OS of all patients were 94.9% and 85.5%, respectively.There was no recurrence or death in low and low-intermediate risk groups. For the high-intermediate risk group,5-year LRRFS and OS were 96.2% and 90.8%, respectively, and for the high risk group 90.5% and 71%. Lategrade 3 and 5 gastrointestinal toxicity was found in 3% and 1.2% of patients, respectively. All of them receivedPRT 5,000 cGy in 25 fractions.
Conclusions: Low and intermediate risk patients had good results with surgeryand adjuvant radiation therapy. For high risk patients, postoperative radiation therapy alone appeared to beinadequate as the most common pattern of failure was distant metastasis.