Neoadjuvant Chemoradiation Therapy Followed by Extrafascial Hysterectomy in Locally Advanced Type II Endometrial Cancer Clinically Extending to Cervix

Practical Radiation Oncology
Uzoma K IheagwaraSushil Beriwal

Abstract

The role of neoadjuvant chemoradiation therapy in locally advanced type II endometrial cancer is controversial. We thus aimed to present our experience with the hypothesis that neoadjuvant chemoradiation therapy is associated with similarly high rates of downstaging and locoregional control for type II endometrial cancer and type I endometrial cancer. Thirty-four patients with type II endometrial cancer with clinical evidence of cervical ± parametrium involvement treated with neoadjuvant external beam radiation therapy (45-50.4 Gy in 25-28 fractions) and high-dose-rate brachytherapy with a median total dose of 20 Gy (range, 15-27.5) in 4 fractions (range, 3-5) and concurrent platinum chemotherapy ± adjuvant chemotherapy from 2008 to 2018 were retrospectively reviewed. Patients with type I pathologic diagnoses and those treated with definitive (rather than preoperative) intent were excluded. Pathologic characteristics were as follows: 38% were carcinosarcoma, 18% serous, and 24% clear cell. Ninety-four percent of patients were downstaged to an extrafascial hysterectomy, and 94% had negative surgical margins. The 2-year local control, regional control, distant control, disease-free survival, and overall survival were 87.8%, 81.3%...Continue Reading

Citations

Jan 6, 2021·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Nicole ConcinCarien L Creutzberg
Feb 20, 2021·Virchows Archiv : an International Journal of Pathology·Nicole ConcinXavier Matias-Guiu
Mar 14, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Nicole ConcinCarien L Creutzberg
May 30, 2021·Critical Reviews in Oncology/hematology·Gaetano PezzicoliStella D'Oronzo

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