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- W2611030410 abstract "Randomized trials have shown benefits in local control with adjuvant radiotherapy (RT) in patients with high-intermediate risk (HIR) endometrial cancer (EC), yet NCCN guidelines allow for observation. We reviewed the National Cancer Data Base (NCDB) to investigate which patient/tumor-related factors influence the delivery of adjuvant RT. The NCDB was queried for patients diagnosed with FIGO 2009 stage 1 endometrioid adenocarcinoma from 1998-2012 who underwent surgery +/- adjuvant RT. Exclusion criteria were: unknown stage or grade, non-endometrioid histology, non-surgical primary therapy, <30 days follow-up, RT>6 months after surgery, or palliative treatment. HIR was defined based on PORTEC-2 trial as: >60y.o with stage IA, grade 3; stage IB, grade 1-2. Factors predictive of delivery of adjuvant RT/type of RT were analyzed by logistic regression. Of the 461,307 patients in the EC database, 13,651 met inclusion criteria. 5,837 (42.8%) received adjuvant RT, while 7,814 (57.2%) received surgery alone. Receipt of adjuvant RT was more likely among women with higher income, Northeastern residence, diagnosis after 2010, >50% myometrial invasion, and receipt of adjuvant chemotherapy (p<0.05). Patients >80y.o or those undergoing lymph node dissection (LND) were less likely to receive adjuvant RT (p<0.05). Of those treated with RT, 44.0% received external beam therapy, 54.8% received vaginal cuff brachytherapy, 0.6% received both, and 0.6% had unknown modality. Patients with age >80y.o, Northeastern residence, treatment at academic facilities, diagnosis between 1998-2004, higher FIGO stage, and LND were more likely to undergo brachytherapy (p<0.05). Overall use of adjuvant RT was 71.2% between 1998-2004, 58.0% between 2005-2010, and 56.6% between 2011-2012; the difference between 1998-2004 and 2005-2010 was not statistically significant. Less than half of patients with HIR EC received adjuvant RT despite strong evidence demonstrating improved local control. Both patient- and tumor-related factors appear to influence delivery of adjuvant RT and the modality selected." @default.
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- W2611030410 date "2017-06-01" @default.
- W2611030410 modified "2023-09-22" @default.
- W2611030410 title "(P046) Factors Predictive of Receiving Adjuvant Radiotherapy in High-Intermediate Risk Stage I Endometrial Cancer" @default.
- W2611030410 doi "https://doi.org/10.1016/j.ijrobp.2017.02.141" @default.
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