Whole abdominal irradiation for tumors of the uterine corpus

Between November 1981 and December 1985, 16 patients with high‐risk tumors of the uterine corpus were treated with a postoperative course of whole abdominal‐pelvic irradiation. Thirteen patients had carcinomas and three had sarcomas. All patients had complete pelvic surgery including extrafascial (or modified radical) hysterectomy and bilateral salpingo‐oophorectomy, pelvic node sampling, evaluation of peritoneal cytology, and resection of extrauterine metastases when indicated. All patients were free of gross visible tumor after surgery. Target doses of radiation were 3000 cGy to the upper abdomen and 4500 cGy to the pelvis. Median follow‐up was 24 months for survivors (range, 17 to 63 months). The disease‐free survival and overall survival at 17 months was 50%. Six of the 16 (38%) patients suffered intraabdominal relapse. One patient had a significant complication (bowel perforation). The data from this pilot study suggest that whole abdominal‐pelvic irradiation may be useful only in the management of some patients with few high risk features of endometrial carcinoma. Patients with extensive extrauterine involvement and with sarcoma histology do not appear to benefit from this experimental therapy.

[1]  P. Grigsby,et al.  Results of therapy, analysis of failures, and prognostic factors for clinical and pathologic stage III adenocarcinoma of the endometrium. , 1987, Gynecologic oncology.

[2]  M. Hendrickson,et al.  Therapeutic approaches to uterine papillary serous carcinoma: a preliminary report. , 1987, Gynecologic oncology.

[3]  L. Gerig,et al.  Stage III carcinoma of the endometrium: A review of 41 cases , 1987 .

[4]  W. Mackillop,et al.  Stage III endometrial carcinoma. A review of 90 cases , 1985, Cancer.

[5]  L. Twiggs,et al.  Role of whole abdominal radiation therapy in the management of endometrial cancer; prognostic importance of factors indicating peritoneal metastases. , 1985, Gynecologic oncology.

[6]  S. Stokes,et al.  Stage I, grade III adenocarcinoma of the endometrium treated with surgery and irradiation. Sites of failure and correlation of failure rate with irradiation technique , 1984, Cancer.

[7]  A. Hamberger,et al.  Treatment of intraperitoneal metastatic adenocarcinoma of the endometrium by the whole-abdomen moving-strip technique and pelvic boost irradiation. , 1983, Gynecologic oncology.

[8]  R. Kempson,et al.  Adenocarcinoma of the endometrium analysis of 256 cases with disease limited to the uterine corpus: Treatment comparisons , 1983 .

[9]  P. Disaia,et al.  Prognostic significance of peritoneal cytology in patients with endometrial cancer and preliminary data concerning therapy with intraperitoneal radiopharmaceuticals. , 1981, American journal of obstetrics and gynecology.

[10]  G. Malkasian,et al.  Radioactive colloidal gold in the treatment of endometrial cancer: Mayo clinic experience, 1952–1976 , 1981, Cancer.

[11]  R. Knapp,et al.  Stage III adenocarcinoma of the endometrium: two prognostic groups. , 1980, Gynecologic oncology.

[12]  M. Feldstein,et al.  Uterine sarcomas. Analysis of failures with special emphasis on the use of adjuvant radiation therapy , 1978, Cancer.

[13]  G. Malkasian.  Carcinoma of the endometrium: Effect of stage and grade on survival , 1978, Cancer.

[14]  P. Rubin,et al.  Endometrial carcinoma: analysis of failures with special emphasis on the use of initial preoperative external pelvic radiation. , 1977, International journal of radiation oncology, biology, physics.

[15]  G. F. G. O. Mǔelenaere.  THE DISTRIBUTION OF NEOPLASM IN PATIENTS DYING AFTER TREATMENT OF ENDOMETRIAL CARCINOMA , 1976 .

[16]  Boronow Rc.  Endometrial cancer: not a benign disease. , 1976, Obstetrics and gynecology.

[17]  Townsend De,et al.  Current management of endometrial carcinoma. , 1973 .