Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista Brasileira de Cancerologia (Online) |
Texto Completo: | https://rbc.inca.gov.br/index.php/revista/article/view/2778 |
Resumo: | Median incidence of endometrial câncer in Brazil is of 6 new cases/100.000 women/year. Radiation therapy has been used as adjuvant treatment either pre or post surgery, given as teletherapy or brachytherapy or both. There is a consensus that FIGO stages II and III should receive pelvic irradiation, with or without brachytherapy. However most of such patients (>75%) have stage I câncer at diagnosis. Thus, there are prognostic subgroups depending on how deep the miometrium is invaded and the histologic grade ofthe tumor. Stage I câncer that invades more than 1/2 miometrium and/or is of high grade usually is also treated with adjuvante irradiation. Does the addition of intracavitary vault brachytherapy to externai beam radiotherapy (EBRT) result in improvedpelvic control? This question is yet to be accurately answered. In our Service, patients with endometrial câncer who have indication of adjuvant radiation have received only EBRT without brachytherapy, since 1990. Basic surgery for those patients has been a total abdominal hysterectomy and bilateral salpingo-oophorectomy without routine lymphnode dissection. We reviewed retrospectively 61 patients with endometrial câncer treated this way between 1990-95, with Cobalt, 4 fields, total dose of 45Gy-50.4Gy in 25 to 28 fractions. Median follow up of33 months showed only one pelvic (vaginal) relapse, 6/61 patients died and only one patient had moderate late bowel complication. Those results compare with others published in the literature. |
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Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode DissectionCâncer do Endométrio: Tratamento Adjuvante Pélvico apenas com Radioterapia Externa após Cirurgia sem LinfadenectomiaCâncer do EndométrioRadioterapiaBraquiterapiaEndometrial CancerRadiotherapyBrachytherapyMedian incidence of endometrial câncer in Brazil is of 6 new cases/100.000 women/year. Radiation therapy has been used as adjuvant treatment either pre or post surgery, given as teletherapy or brachytherapy or both. There is a consensus that FIGO stages II and III should receive pelvic irradiation, with or without brachytherapy. However most of such patients (>75%) have stage I câncer at diagnosis. Thus, there are prognostic subgroups depending on how deep the miometrium is invaded and the histologic grade ofthe tumor. Stage I câncer that invades more than 1/2 miometrium and/or is of high grade usually is also treated with adjuvante irradiation. Does the addition of intracavitary vault brachytherapy to externai beam radiotherapy (EBRT) result in improvedpelvic control? This question is yet to be accurately answered. In our Service, patients with endometrial câncer who have indication of adjuvant radiation have received only EBRT without brachytherapy, since 1990. Basic surgery for those patients has been a total abdominal hysterectomy and bilateral salpingo-oophorectomy without routine lymphnode dissection. We reviewed retrospectively 61 patients with endometrial câncer treated this way between 1990-95, with Cobalt, 4 fields, total dose of 45Gy-50.4Gy in 25 to 28 fractions. Median follow up of33 months showed only one pelvic (vaginal) relapse, 6/61 patients died and only one patient had moderate late bowel complication. Those results compare with others published in the literature.A incidência mediana de câncer endometrial no Brasil é de 6 casos novos/cem mil mulheres/ ano. A radioterapia tem sido usada como tratamento adjuvante pré ou pós cirurgia, com ou sem braquiterapia. Há consenso de que os casos estadiados como II e III pela FIGO recebam irradiação pélvica, com ou sem braquiterapia. Entretanto, 75% dos casos são estádios I. Por isso há subgrupos prognósticos que dependem da profundidade de invasão do miométrio e do grau histológico do tumor. Tumores em estádio I com invasão profunda do miométrio e/ou alto grau têm também sido tratados com irradiação. A adição de braquiterapia vaginal após a radioterapia externa resulta em melhor controle de falha pélvica? Esta é uma pergunta não resolvida. Desde 1990 temos feito apenas radioterapia externa nos casos de câncer do endométrio que têm indicação de irradiação adjuvante, sem braquiterapia. A cirurgia básica destes casos têm sido histerectomia abdominal total + salpingo-ooforectomia bilateral sem dissecção de rotina dos linfonodos pélvicos. Foram revistas retrospectivamente 61 destes casos tratados no nosso serviço, com 4 campos pélvicos. Cobalto, dose total entre 45Gy-50,4Gy em 25 a 28 frações. Seguimento mediano de 33 meses mostrou um único caso de falha em vagina, 6/61 casos de pacientes que morreram e apenas um caso de complicação intestinal moderada. Estes resultados se assemelham com outros da literatura que não usam a braquiterapia de rotina após a irradiação externa na pelve.INCA2022-09-21info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArtigos, Avaliado pelos paresapplication/pdfhttps://rbc.inca.gov.br/index.php/revista/article/view/277810.32635/2176-9745.RBC.1999v45n3.2778Revista Brasileira de Cancerologia; Vol. 45 No. 3 (1999): July/Aug./Sept.; 9-14Revista Brasileira de Cancerologia; Vol. 45 Núm. 3 (1999): jul./ago./sept.; 9-14Revista Brasileira de Cancerologia; v. 45 n. 3 (1999): jul./ago./set.; 9-142176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAporhttps://rbc.inca.gov.br/index.php/revista/article/view/2778/1654https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessFaria, Sérgio LuizFerrigno, Robson2023-01-18T15:15:10Zoai:rbc.inca.gov.br:article/2778Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2023-01-18T15:15:10Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false |
dc.title.none.fl_str_mv |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection Câncer do Endométrio: Tratamento Adjuvante Pélvico apenas com Radioterapia Externa após Cirurgia sem Linfadenectomia |
title |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection |
spellingShingle |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection Faria, Sérgio Luiz Câncer do Endométrio Radioterapia Braquiterapia Endometrial Cancer Radiotherapy Brachytherapy |
title_short |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection |
title_full |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection |
title_fullStr |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection |
title_full_unstemmed |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection |
title_sort |
Endometrial Câncer: Pelvic Control with only Externai Beam Radiotherapy Following Surgery Without Lymphnode Dissection |
author |
Faria, Sérgio Luiz |
author_facet |
Faria, Sérgio Luiz Ferrigno, Robson |
author_role |
author |
author2 |
Ferrigno, Robson |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Faria, Sérgio Luiz Ferrigno, Robson |
dc.subject.por.fl_str_mv |
Câncer do Endométrio Radioterapia Braquiterapia Endometrial Cancer Radiotherapy Brachytherapy |
topic |
Câncer do Endométrio Radioterapia Braquiterapia Endometrial Cancer Radiotherapy Brachytherapy |
description |
Median incidence of endometrial câncer in Brazil is of 6 new cases/100.000 women/year. Radiation therapy has been used as adjuvant treatment either pre or post surgery, given as teletherapy or brachytherapy or both. There is a consensus that FIGO stages II and III should receive pelvic irradiation, with or without brachytherapy. However most of such patients (>75%) have stage I câncer at diagnosis. Thus, there are prognostic subgroups depending on how deep the miometrium is invaded and the histologic grade ofthe tumor. Stage I câncer that invades more than 1/2 miometrium and/or is of high grade usually is also treated with adjuvante irradiation. Does the addition of intracavitary vault brachytherapy to externai beam radiotherapy (EBRT) result in improvedpelvic control? This question is yet to be accurately answered. In our Service, patients with endometrial câncer who have indication of adjuvant radiation have received only EBRT without brachytherapy, since 1990. Basic surgery for those patients has been a total abdominal hysterectomy and bilateral salpingo-oophorectomy without routine lymphnode dissection. We reviewed retrospectively 61 patients with endometrial câncer treated this way between 1990-95, with Cobalt, 4 fields, total dose of 45Gy-50.4Gy in 25 to 28 fractions. Median follow up of33 months showed only one pelvic (vaginal) relapse, 6/61 patients died and only one patient had moderate late bowel complication. Those results compare with others published in the literature. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-09-21 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Artigos, Avaliado pelos pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/2778 10.32635/2176-9745.RBC.1999v45n3.2778 |
url |
https://rbc.inca.gov.br/index.php/revista/article/view/2778 |
identifier_str_mv |
10.32635/2176-9745.RBC.1999v45n3.2778 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/2778/1654 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
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https://creativecommons.org/licenses/by/4.0 |
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openAccess |
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application/pdf |
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INCA |
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INCA |
dc.source.none.fl_str_mv |
Revista Brasileira de Cancerologia; Vol. 45 No. 3 (1999): July/Aug./Sept.; 9-14 Revista Brasileira de Cancerologia; Vol. 45 Núm. 3 (1999): jul./ago./sept.; 9-14 Revista Brasileira de Cancerologia; v. 45 n. 3 (1999): jul./ago./set.; 9-14 2176-9745 reponame:Revista Brasileira de Cancerologia (Online) instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) instacron:INCA |
instname_str |
Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
instacron_str |
INCA |
institution |
INCA |
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Revista Brasileira de Cancerologia (Online) |
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Revista Brasileira de Cancerologia (Online) |
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Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
repository.mail.fl_str_mv |
rbc@inca.gov.br |
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