Primary radiation therapy for medically inoperable patients with clinical stage i and II endometrial carcinoma

Iwona Podzielinski, Marcus E. Randall, Patrick J. Breheny, Pedro F. Escobar, David E. Cohn, Allison M. Quick, Junzo P. Chino, Micael Lopez-Acevedo, Jana L. Seitz, Jennifer E. Zook, Leigh G. Seamon

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)36-41
Number of pages6
JournalGynecologic Oncology
Volume124
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • Co-morbidities
  • Endometrial cancer
  • Medically inoperable
  • Radiation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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