J Gynecol Oncol.
2019 Jul;30(4):e53. 10.3802/jgo.2019.30.e53.
Impact of vaginal brachytherapy in intermediate and high-intermediate risk endometrial cancer: a multicenter study from the FRANCOGYN group
- Reboux PA
- Azaïs H
- Canova CH
- Bendifallah S
- Ouldamer L
- Raimond E
- Hudry D
- Coutant C
- Graesslin
- Touboul C
- Collinet P
- Bricou A
- Huchon C
- Daraï E
- Ballester
- Lévêque
- Lavoué V
- Koskas M
- Uzan C
- Canlorbe G
- Affiliations
-
- 1Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Institut Universitaire de Cancérologie (IUC), Paris, France. geoffroy.canlorbe@aphp.fr
- 2Department of Radiation Oncology, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Paris, France.
- 3Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, Institut Universitaire de Cancérologie (IUC), Paris, France.
- 4INSERM UMR_S_938, "Cancer Biology and Therapeutics", Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris, France.
- 5Department of Gynecology, Centre Hospitalier Universitaire de Tours, Tours, France; INSERM U1069, Université François-Rabelas, Tours, France.
- 6Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
- 7Center de Lutte Contre le Cancer Georges François Leclerc, Dijon, France.
- 8Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France.
- 9Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire, Lille, France.
- 10Department of Gynaecology and Obstetrics, Jean Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris 13, Bondy, France.
- 11Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal, Poissy, France.
- 12CHU de Rennes, Service de Gynécologie, Hopital Sud, Université de Rennes 1, Rennes, France.
- 13INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Rennes, France.
- 14Division of Gynecologic Oncology, Bichat University Hospital, Paris, France.
- KMID: 2450232
- DOI: http://doi.org/10.3802/jgo.2019.30.e53
Abstract
OBJECTIVE
According to recent European Society of Medical Oncology, European Society of Gynaecological Oncology and European Society of Radiotherapy and Oncology guidelines, adjuvant vaginal brachytherapy (VB) is optional in patients with intermediate risk (IR) and high-intermediate risk (HIR) endometrial cancer (EC). The aim of this French retrospective, multicenter study was to assess the impact of VB in these groups on local recurrence rate, local recurrence-free survival (RFS) and overall survival (OS).
METHODS
Data of 191 patients with IR and HIR EC who underwent primary surgery with or without VB and no other adjuvant treatment between 2000 and 2016 were extracted from the FRANCOGYN database. Rate of local recurrence, OS and local RFS in these two groups were compared using the Kaplan-Meier method.
RESULTS
The number of patients with IR and HIR EC were 118 and 73 respectively. VB was used in 92 patients in IR group and 43 in HIR group. Median follow-up was 22 months. In the HIR group, the local recurrence rate was significantly higher in the no adjuvant therapy group in comparison with the VB group (16.7% and 0% respectively, p=0.02). There was also a significant improvement in local RFS (p=0.01) in VB group. In IR EC, there is no significant difference on local recurrence rate (4.2% and 3.2%, respectively, p=1.00) or local RFS (p=0.54) between the two groups.
CONCLUSIONS
VB is an efficient adjuvant treatment for patients with HIR EC. VB is not associated with an improvement of RFS or OS in IR EC patient.
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