[子宮內膜癌] 術後放射線治療

關於子宮內膜癌, 術後放射線治療的論文非常多, 以下一一來整理

1. GOG 99: 有子宮肌層 且/或 occult cervical stroma侵犯(定義三個risk factor : grade II/III, LVI, outer 1/3 myometrial invasion, 定義 high-intermediate risk pts 為(1) age>70 with 1 risk factor (2) age >50 with 2 risk factor (3) any age with 3 risk factor; 其他收案病人不符合high-intermediate risk 的都定義為 low-intermediate risk), 去做TAH/BSO, pelvic, P-A LN sampling, 和 peritoneal cytology, 之後分成 whole pelvis RT(50.4Gy) v.s 觀察, 發現WPRT 可以改善 2-year cumulative incidence of recurrence (12%->3%), 其中high-intermediate risk(26%->6%), low-intermediate risk(6%->3%), OS在兩組沒差(但是power不夠...)

2. PORTEC-1:  PORTEC為post operative radiation therapy in endometrial carcinoma的縮寫, 收案條件為stage-1 endometrial carcinoma (grade 1 with deep [≥50%] myometrial invasion, grade 2 with any invasion, or grade 3 with superficial [<50%] invasion), 去做TAH/BSO without lymphadenectomy, 隨機分成EBRT(46Gy) v.s. observation, EBRT reduce 10 year Loco-regional recurrence(14% to 5%), 10-yr OS 沒差

3. PORTEC-2:


reference:

1. Keys, Henry M., et al. "A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: a Gynecologic Oncology Group study." Gynecologic oncology 92.3 (2004): 744-751.

2. Creutzberg, Carien L., et al. "Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial." The Lancet 355.9213 (2000): 1404-1411.

3. Scholten, Astrid N., et al. "Postoperative radiotherapy for Stage 1 endometrial carcinoma: long-term outcome of the randomized PORTEC trial with central pathology review." International Journal of Radiation Oncology* Biology* Physics 63.3 (2005): 834-838