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KMID : 0362919950130040377
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Journal of the Korean Society for Therapeutic Radiology and Oncology
1995 Volume.13 No. 4 p.377 ~ p.383
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Comparative Analysis between preoperative Radiatherapy and postoperative Radiotherapy in Clinical Stage I and II Endometrial Carcinoma
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Keum Ki-Chang
Lee Chang-Geol
Chung Eun-Ji
Lee Sang-Wook
Kim Woo-Cheol
Chang Sei-Kyung
Oh Young-Taek
Suh Chang-Ok
Kim Gwi-Eon
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Abstract
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Purpose: To obtain the optical treatment method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy(pre-op R) and postoperative radiotherapy(post-op RT).
Materials and Methods: A retrospctive review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stage I; 12 patients, Stage II; 7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO(Bilateral Salphingoophorectomy) (Group 1) and 43 patients( Stage 1; 32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT was administered on 4-5 weeks following surgery. All patients exept 1 patient(Group2; ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55Gy(median 45Gy) in 5-6week through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180cGy per fraction. ICR doses were prescreibed to point A(20-39.6 Gy, median 39Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy, median 21Gy) in Group2.
Results: The overall 5year survival rate was 95%. No survival difference between pre-op and post-op RT group.(89.3% vs 97.7%, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1(p>0.1), but affected by presence of lymph node metastasis in post-op RT group(p<0.5). The complication rate of pre-op RT group was higher than post-op RT.(16% vs 5%)
Conclusion : Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate.
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KEYWORD
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Endomerial carcinoma, Preoperative radiotherapy, Postoperative radiotherapy
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