TY - JOUR
T1 - Primary radiation therapy for medically inoperable patients with clinical stage i and II endometrial carcinoma
AU - Podzielinski, Iwona
AU - Randall, Marcus E.
AU - Breheny, Patrick J.
AU - Escobar, Pedro F.
AU - Cohn, David E.
AU - Quick, Allison M.
AU - Chino, Junzo P.
AU - Lopez-Acevedo, Micael
AU - Seitz, Jana L.
AU - Zook, Jennifer E.
AU - Seamon, Leigh G.
PY - 2012/1
Y1 - 2012/1
N2 - Objective: To determine the outcomes associated with primary radiation therapy for medically inoperable, clinical stage I and II, endometrial adenocarcinoma (EAC). Methods: A multi-institution, retrospective chart review from January 1997 to January 2009 was performed. Overall survival (OS), disease-specific survival (DSS), progression-free survival (PFS) and time to progression (TTP) were assessed using the Kaplan-Meier method. Disease-specific survival was analyzed using a competing risks approach. Results: Seventy-four patients were evaluable. The median age and BMI were 65 years (range 36-92 years) and 46 kg/m 2 (range 23-111 kg/m 2), respectively. 85.1% had severe systemic disease, most frequently cardiopulmonary risk and morbid obesity. With a mean follow-up of 31 months, 13 patients (17.6%) experienced a recurrence. The median PFS and OS were 43.5 months and 47.2 months, respectively. Overall, 35 women died, including 4 women who died of unknown cause. Of the remaining 31 women, 7 patients (9.5%) died of disease, while 24 died of other causes (32.4%). The hazard ratio comparing the risk of death due to other causes to the risk of death due to disease was 3.4 (95% CI 1.4-9.4, p = 0.003). Among patients who are alive three years after diagnosis, 14% recurred and the conditional recurrence estimate did not exceed 16%. Conclusions: Primary radiation therapy for clinical stage I and II EAC is a feasible option for medically inoperable patients and provides disease control, with fewer than 16% of surviving patients experiencing recurrence.
AB - Objective: To determine the outcomes associated with primary radiation therapy for medically inoperable, clinical stage I and II, endometrial adenocarcinoma (EAC). Methods: A multi-institution, retrospective chart review from January 1997 to January 2009 was performed. Overall survival (OS), disease-specific survival (DSS), progression-free survival (PFS) and time to progression (TTP) were assessed using the Kaplan-Meier method. Disease-specific survival was analyzed using a competing risks approach. Results: Seventy-four patients were evaluable. The median age and BMI were 65 years (range 36-92 years) and 46 kg/m 2 (range 23-111 kg/m 2), respectively. 85.1% had severe systemic disease, most frequently cardiopulmonary risk and morbid obesity. With a mean follow-up of 31 months, 13 patients (17.6%) experienced a recurrence. The median PFS and OS were 43.5 months and 47.2 months, respectively. Overall, 35 women died, including 4 women who died of unknown cause. Of the remaining 31 women, 7 patients (9.5%) died of disease, while 24 died of other causes (32.4%). The hazard ratio comparing the risk of death due to other causes to the risk of death due to disease was 3.4 (95% CI 1.4-9.4, p = 0.003). Among patients who are alive three years after diagnosis, 14% recurred and the conditional recurrence estimate did not exceed 16%. Conclusions: Primary radiation therapy for clinical stage I and II EAC is a feasible option for medically inoperable patients and provides disease control, with fewer than 16% of surviving patients experiencing recurrence.
KW - Co-morbidities
KW - Endometrial cancer
KW - Medically inoperable
KW - Radiation
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UR - http://www.scopus.com/inward/citedby.url?scp=83055184395&partnerID=8YFLogxK
U2 - 10.1016/j.ygyno.2011.09.022
DO - 10.1016/j.ygyno.2011.09.022
M3 - Article
C2 - 22015042
AN - SCOPUS:83055184395
SN - 0090-8258
VL - 124
SP - 36
EP - 41
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 1
ER -
