Preoperative radiotherapy in stage I/II endometrial adenocarcinoma
Identifieur interne : 000892 ( France/Analysis ); précédent : 000891; suivant : 000893Preoperative radiotherapy in stage I/II endometrial adenocarcinoma
Auteurs : P. Maingon [France] ; J. C. Horiot [France] ; J. Fraisse [France] ; S. Salas [France] ; F. Collin [France] ; M. C. Bône-Lepinoy [France] ; I. Barillot [France] ; S. Douvier [France] ; M. M. Padéano [France] ; J. Cuisenier [France]Source :
- Radiotherapy and Oncology [ 0167-8140 ] ; 1996.
Abstract
From 1972 to 1993,170 patients received preoperative radiotherapy followed, 5–6 weeks later, by total extrafascial hysterectomy with bilateral salpingo-oophorectomy without lymphadenectomy. Eighty-three patients with good prognostic factors (low grade tumour and no cervical involvement) received low dose rate utero vaginal brachytherapy alone before surgery (Group 1). Eighty-seven patients with poor prognostic factors (high grade tumors and/or cervical involvement) received external radiotherapy to 40 Gy and low dose rate brachytherapy before surgery (Group 2). A single vaginal failure was observed (0.6%). The overall pelvic failure rate was 2.3% (four patients) including two cases with pelvic recurrence and metastases. Three of the four pelvic failures occurred in Group 1. Using the 1971 FIGO clinical staging, 5-year disease-free survival was 82% in Stage Ia, 79% in Stage Ib, and 81% in Stage II (P = 0.36). Five-year disease-free survival was 86% in Grade 1, 76% in Grade 2, and 83% in Grade 3 (P = 0.20). Five-year overall survival was 83% in Stage Ia, 79% in Stage Ib, and 83% in Stage II (P = 0.78). Five-year overall survival was 88% in Grade 1, 77% in Grade 2,83% in Grade 3 (P = 0.27). Complications were recorded with the French-Italian syllabus. Grade 2 complications occurred in 12 cases (7%), Grade 3 in five cases (3%). The lack of correlation between classical risk factors (stage, grade) and disease outcome suggests that preoperative radiotherapy strategies should be preferred when such factors can be identified before surgery.
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DOI: 10.1016/0167-8140(96)01743-4
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Cuisenier</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Centre Georges-François-Leclerc, 1 rue du Professeur Marion, 21035 Dijon</wicri:regionArea><wicri:noRegion>21035 Dijon</wicri:noRegion><wicri:noRegion>21035 Dijon</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Radiotherapy and Oncology</title><title level="j" type="abbrev">RADION</title><idno type="ISSN">0167-8140</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1996">1996</date><biblScope unit="volume">39</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="201">201</biblScope><biblScope unit="page" to="208">208</biblScope></imprint><idno type="ISSN">0167-8140</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0167-8140</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">From 1972 to 1993,170 patients received preoperative radiotherapy followed, 5–6 weeks later, by total extrafascial hysterectomy with bilateral salpingo-oophorectomy without lymphadenectomy. Eighty-three patients with good prognostic factors (low grade tumour and no cervical involvement) received low dose rate utero vaginal brachytherapy alone before surgery (Group 1). Eighty-seven patients with poor prognostic factors (high grade tumors and/or cervical involvement) received external radiotherapy to 40 Gy and low dose rate brachytherapy before surgery (Group 2). A single vaginal failure was observed (0.6%). The overall pelvic failure rate was 2.3% (four patients) including two cases with pelvic recurrence and metastases. Three of the four pelvic failures occurred in Group 1. Using the 1971 FIGO clinical staging, 5-year disease-free survival was 82% in Stage Ia, 79% in Stage Ib, and 81% in Stage II (P = 0.36). Five-year disease-free survival was 86% in Grade 1, 76% in Grade 2, and 83% in Grade 3 (P = 0.20). Five-year overall survival was 83% in Stage Ia, 79% in Stage Ib, and 83% in Stage II (P = 0.78). Five-year overall survival was 88% in Grade 1, 77% in Grade 2,83% in Grade 3 (P = 0.27). Complications were recorded with the French-Italian syllabus. Grade 2 complications occurred in 12 cases (7%), Grade 3 in five cases (3%). The lack of correlation between classical risk factors (stage, grade) and disease outcome suggests that preoperative radiotherapy strategies should be preferred when such factors can be identified before surgery.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Bourgogne</li><li>Bourgogne-Franche-Comté</li></region><settlement><li>Dijon</li></settlement></list><tree><country name="France"><region name="Bourgogne-Franche-Comté"><name sortKey="Maingon, P" sort="Maingon, P" uniqKey="Maingon P" first="P." last="Maingon">P. Maingon</name></region><name sortKey="Barillot, I" sort="Barillot, I" uniqKey="Barillot I" first="I." last="Barillot">I. Barillot</name><name sortKey="Bone Lepinoy, M C" sort="Bone Lepinoy, M C" uniqKey="Bone Lepinoy M" first="M. C." last="Bône-Lepinoy">M. C. Bône-Lepinoy</name><name sortKey="Collin, F" sort="Collin, F" uniqKey="Collin F" first="F." last="Collin">F. Collin</name><name sortKey="Cuisenier, J" sort="Cuisenier, J" uniqKey="Cuisenier J" first="J." last="Cuisenier">J. Cuisenier</name><name sortKey="Douvier, S" sort="Douvier, S" uniqKey="Douvier S" first="S." last="Douvier">S. Douvier</name><name sortKey="Fraisse, J" sort="Fraisse, J" uniqKey="Fraisse J" first="J." last="Fraisse">J. Fraisse</name><name sortKey="Horiot, J C" sort="Horiot, J C" uniqKey="Horiot J" first="J. C." last="Horiot">J. C. Horiot</name><name sortKey="Padeano, M M" sort="Padeano, M M" uniqKey="Padeano M" first="M. M." last="Padéano">M. M. Padéano</name><name sortKey="Salas, S" sort="Salas, S" uniqKey="Salas S" first="S." last="Salas">S. 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