Adjuvant vaginal brachytherapy and chemotherapy versus pelvic radiotherapy in early-stage endometrial cancer: Outcomes by risk factors.
Gynecol Oncol
; 155(3): 429-435, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-31610885
ABSTRACT
OBJECTIVE:
To report on patterns of care as well as evaluate the two treatment regimens using a large retrospective hospital-based registry to identify possible subgroups of patients who may experience benefit with VBT + CT vs. EBRT.METHODS:
Patients from the National Cancer Database (NCDB) were identified who met the inclusion criteria for GOG 249 and were treated with either VBT + CT or WPRT. Demographic, clinicopathologic, and treatment factors were collected. Association of treatment type and other variables with overall survival was analyzed using Cox proportional hazards model. Subset analyses were performed based on a variety of risk factors, including high risk pathologies, surgical nodal sampling, and grade.RESULTS:
A total of 4,602 patients were included in the analysis, with 41% receiving VBT + CT and 59% receiving WPRT. For the entire cohort, VBT + CT was associated with improved survival, with 3-year overall survival 89.6% vs. 87.8% (hazard ratio 1.24, 95%CI 1.01-1.52, p = 0.04). On subset analysis, patients with serous histology experienced benefit with VBT + CT, while high-grade endometrial patients without lymph node dissection experienced improved survival associated with EBRT. After exclusion of serous histology, there was no survival difference associated with treatment type.CONCLUSIONS:
VBT + CT was associated with superior survival outcomes in patients with early-stage serous carcinoma. For non-serous histology, treatment modality was not associated with a difference in survival, although patients with high-grade disease and no nodal dissection experienced benefit from EBRT.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Braquiterapia
/
Neoplasias do Endométrio
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article