Faculty Collaboration Database

Does brachytherapy improve survival in addition to external beam radiation therapy in patients with high risk stage I and II endometrial carcinoma? Am J Clin Oncol 2010 Aug;33(4):364-9

Date

08/07/2010

Pubmed ID

20689365

DOI

10.1097/COC.0b013e3181b0c266

Scopus ID

2-s2.0-77956628579   14 Citations

Abstract

INTRODUCTION: The benefit of adjuvant external beam radiation therapy (EBRT) in combination with intravaginal brachytherapy (BT) in stage I and II endometrial adenocarcinoma remains controversial. We evaluated the effect of adjuvant EBRT and combined EBRT + BT on overall survival and relative survival within a large US population database.

METHODS: We performed an analysis of retrospective data from the Surveillance, Epidemiology, and End Results (SEER) program of the US National Cancer Institute from January 1, 1998 to December 31, 2005. A total of 3395 patients with stages IB, IC, and II node-negative endometrial adenocarcinoma comprised the population. Overall survival (OS) and relative survival (RS) curves were constructed via the Kaplan-Meier method and subgroups were compared via stratified log-rank test within T stage/grade combinations. Cox proportional hazards modeling was performed to evaluate the effect of multiple variables.

RESULTS: EBRT alone was used in 2128 patients (62.7%) and 1267 patients (37.3%) received a combination of EBRT + BT. Higher grade, black race, older age at diagnosis, and later year of diagnosis are associated with worse overall survival, while lymphadenectomy is associated statistically with improved survival. The addition of BT revealed no statistically significant effect on OS.

CONCLUSIONS: This large population-based study revealed no improvement in OS or RS with the addition of BT to EBRT in high risk stage I and stage II endometrial cancer. Although specific patient cohorts may benefit from combined EBRT and BT, additional analysis is warranted to further elucidate optimal treatment strategies for adjuvant radiotherapy based on specific clinical and pathologic features.

Author List

Crosby MA, Tward JD, Szabo A, Lee CM, Gaffney DK

Author

Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age of Onset
Brachytherapy
Combined Modality Therapy
Endometrial Neoplasms
Female
Humans
Lymph Node Excision
Multivariate Analysis
Neoplasm Staging
Proportional Hazards Models
Radiotherapy
SEER Program
Survival Rate
Uterine Neoplasms