Radiation and Chemoradiation Therapy for I Stage Intermediate and High/Intermediate Endometrial Cancer – Descriptive Analysis

Abstract

Introduction. Endometrial cancer ranks the third place in prevalence among all cancers in Ukraine. The surgical treatment and subsequent adjuvant treatment is planned according to the patient's risk group. The choice of radiation therapy and the need to add chemotherapy determines the level of recurrence-free survival. Objective. The aim of the study was to analyze the database of treated patients in National Cancer Institute, with I stage endometrial cancer intermediate and high-intermediate group; determination of the most frequent choice of radiation treatment in accordance with the risk group of patients with a hysterectomy with salpingo-oophorectomy for further observation and evaluation of diseasefree survival. Materials and methods. Retrospective was analysed 245 patients with high and intermediate risk groups with stage I endometrial cancer. The exclusion criteria were: low-risk patients, stages II–IV and non-endometrioid histological variant. Results. According to the analysis, there were 122/245 (49.8 %) patients of high risk group, 123/245 (50.2 %) of intermediate risk group. High-risk patients underwent external beam therapy and brychytherapy, supplemented by chemotherapy in 5.8 % of cases (7 patients), brachytherapy with external beam therapy was performed in 58.2 % of cases (71 patients), brachytherapy – in 8.1 % of cases (10 patients), external beam therapy was performed in 27.9 % cases. Intermediate and high-intermediate risk patients were distributed as follows: brachytherapy was performed in 41.5 % of cases (51 patients), brachytherapy with external beam therapy – 54.5 % (67 patients), external beam therapy was performed in 5 patients. Conclusion. Brachytherapy is available for patients with intermediate risk endometrial cancer and external beam therapy with possible addition of brachytherapy is recommended for high-intermediate and high-risk groups, especially in patients with lymphatic vascular involvement. All patients are monitored for further assessment of recurrence-free survival. Key words: endometrial cancer, lymphadenectomy, external beam therapy, chemo- and radiotherapy.