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Outcomes of intermediate-risk to high-risk stage Ⅰ endometrial cancer: 10-year clinical experiences of using in-house multi-channel applicators in a single center

摘要Background:There are only very few reports on clinical outcomes using multi-channel applicators (MCA) for patients with endometrial cancer (EC) in China.We aimed to evaluate the clinical experience of treating intermediate-risk (IR) to high-risk (HR) stage Ⅰ EC using in-house made multi-channel applicators (IH-MCA) in a single institution.Methods:Three hundred and ninety patients with stage Ⅰ IR to HR EC were treated with hysterectomy and adjuvant radiotherapy from 2003 to 2015.All patients received post-operative vaginal cuff brachytherapy (VBT) alone or as a boost after external beam radiotherapy (EBRT).The prescriptions were 500 cGy per fraction for a total of 5 to 6 fractions with brachytherapy alone or 400 to 600 cGy per fraction for 2 to 3 fractions if it was combined with EBRT.Two types of applicators including a traditional rigid IH-MCA and a recent model custom-made with 3 dimension printing technology were used for treatment.The Kaplan-Meier method was used to calculate survival rate.Results:Follow-up rate was 92.8% and the median follow-up time was 48 months (range 4-172 months).The 5-year overall survival (OS),progression-free survival,local recurrence,and distant metastasis rates for all patients were 96.3%,92.1%,2.9%,and 4.8% respectively.Two patients had isolated relapse in vagina outside the irradiated volume.The univariate and multivariate analysis showed that age and grade were the prognostic factors correlated with OS (hazard ratio:0.368,95% confidence interval [CI]:0.131-1.035,P =0.048;hazard ratio:0.576,95% CI:0.347--0.958,P =0.026,).Conclusions:For patients with IR to HR stage Ⅰ EC,adjuvant VBT alone or in combination with EBRT using IH-MCA led to excellent survival and recurrence rates.Age and grade were the prognostic factors correlated with OS.

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作者单位 Department of Radiation Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China [1]
栏目名称 Original Articles
DOI 10.1097/CM9.0000000000000382
发布时间 2019-09-11
基金项目
This study was supported by the grant from the Ministry of Science and Technology of China
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