Outcomes of Adjuvant Chemotherapy and Vaginal Brachytherapy with or without Pelvic External Beam Radiation for Surgical Stage I-II Uterine Serous Carcinoma

The role of vaginal brachytherapy in stage I endometrial serous cancer: a systematic review

“…All studies were retrospective [19,20,21,22,23,24,25,26,27]. In accordance with the selection criteria, only data from the VBT treatment arms were extracted and considered for the analysis.…”

“…There is general agreement that complete surgical staging in this high-risk population should consist of peritoneal cytology, omentectomy, and pelvic and para-aortic lymph node dissection; however, the specific nodal counts required (selective sampling vs. complete dissection), and the extent of omental and peritoneal evaluation remain controversial and institution-dependent. Three retrospective studies compared efficacy between EBRT and VBT in patients with stage I USC [19,25,45,46]. While Modh et al, in patients treated with VBT, reported longer 5-year survival rates than those treated with EBRT (VBT: 84% vs. EBRT: 75%; p < 0.001) [45], the other two studies showed no benefit from adding pelvic EBRT to VBT in terms of OS and LC [19,25].…”

Adjuvant Radiation Therapy for Patients With Type II Endometrial Carcinoma

“…In a recently published study for early-stage patients with USC who received chemotherapy, the addition of pelvic radiation treatment to vaginal cuff brachytherapy did not result in a statistically significant clinical benefit. 11 A primary limitation of this current study is the inherent bias associated with its retrospective nature. Although the sample size of this study is relatively small, it is one of the largest single-institution studies that included only surgically staged patients with early-stage type II EC.…”

“…Various radiation treatment volumes include VB alone, 11,17,18 pelvic external beam RT alone, 10 combination of both, 11,20 and whole abdominal RT 19,25 were used. In a recently published study for early-stage patients with USC who received chemotherapy, the addition of pelvic radiation treatment to vaginal cuff brachytherapy did not result in a statistically significant clinical benefit.…”

Does Lower Uterine Segment Involvement in Grade 3 Endometrial Cancer Impact Recurrence Patterns and Patient Outcomes?

“…While it would likely be inefficient to design a trial specifically to answer this question, one may be able to derive this information based on secondary analysis of the GOG 249 which is a phase III randomized controlled trial comparing adjuvant chemoradiation versus chemotherapy alone for women with early stage, high-risk endometrial cancer. In either case, since the majority of recurrences in the LUS involvement were distant, adjuvant chemotherapy should be considered, particularly in patients with high-grade histology who otherwise would not have received adjuvant treatment given lack of meeting criteria for other high-risk prognostic features [5,17,19,20].…”