摘要
Objective.:To assess local control and chronic toxicity with IMRT for adjuvant treatment of endometrial carcinoma. Methods.:Forty-seven patients with endometrial cancerwere treated with adjuvant IMRT and HDR brachytherapy (HDRB). The external beam dose was between 45 and 50.4 Gy,and all patients received 10Gy in 2 fractions of HDRB to the vaginal cuff. Eight of these patients were treated with extended field to include the paraaortic region. Results.:IMRT dosimetry showed excellent coverage of the planning target volume (PTV) with mean PTV 95,PTV 110 and PTV 120 of 97.8%,8.2%and 0.9%respectively. At a median follow-up of 20 months,four patients have recurred at extra pelvic sites. No patient had pelvic recurrence. The treatment was well tolerated with late toxicities as follows:small bowel grade 1:25%,rectal grade 1:2%and bladder grade 1:13%. One patient had grade 3 small bowel toxicity. The 3-year actuarial rate of grade 2 or greater toxicity,disease-free survival and overall survival rate were 3.3%,84%and 90%,respectively. Conclusions.:The preliminary analysis of IMRT for adjuvant treatment of endometrial carcinoma shows excellent local control and low toxicity. However,longer follow-up and more patients are needed to ascertain whether the benefits of IMRT treatment seen here translate into long-term reductions in toxicities and local recurrence.
Objective.:To assess local control and chronic toxicity with IMRT for adjuvant treatment of endometrial carcinoma. Methods.:Forty-seven patients with endometrial cancerwere treated with adjuvant IMRT and HDR brachytherapy (HDRB). The external beam dose was between 45 and 50.4 Gy,and all patients received 10Gy in 2 fractions of HDRB to the vaginal cuff. Eight of these patients were treated with extended field to include the paraaortic region. Results.:IMRT dosimetry showed excellent coverage of the planning target volume (PTV) with mean PTV 95,PTV 110 and PTV 120 of 97.8%,8.2%and 0.9%respectively. At a median follow-up of 20 months,four patients have recurred at extra pelvic sites. No patient had pelvic recurrence. The treatment was well tolerated with late toxicities as follows:small bowel grade 1:25%,rectal grade 1:2%and bladder grade 1:13%. One patient had grade 3 small bowel toxicity. The 3-year actuarial rate of grade 2 or greater toxicity,disease-free survival and overall survival rate were 3.3%,84%and 90%,respectively. Conclusions.:The preliminary analysis of IMRT for adjuvant treatment of endometrial carcinoma shows excellent local control and low toxicity. However,longer follow-up and more patients are needed to ascertain whether the benefits of IMRT treatment seen here translate into long-term reductions in toxicities and local recurrence.
