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• W3093859425 abstract "Studies of salvage radiotherapy (RT) in locally-recurrent endometrial cancer remain limited. However, such data are essential when considering omission of RT post-hysterectomy. We evaluated 30 patients treated with salvage external-beam RT (EBRT) and/or vaginal brachytherapy (VBT) for vaginal relapses of endometrial cancer between 2009 and 2018. Endpoints included local control (LC), regional control (RC), metastasis-free interval (MFI), disease-free interval (DFI), disease-free survival (DFS), and overall survival (OS). Outcomes were evaluated via Kaplan-Meier, with log-rank test employed to compare differences among various groups and identify prognostic factors. Thirty patients developed vaginal recurrence at a median time of 20.6 months (range: 2—219) post-hysterectomy, including 9 who received adjuvant chemotherapy and 1 patient treated with adjuvant VBT at initial presentation. The most common site of recurrence was the apex (60%), followed by the distal vagina (10%). Salvage RT entailed combination EBRT and VBT (n = 24) or single modality treatment (n = 6), along with concurrent chemotherapy in 20 cases. At a median follow-up of 4.4 years post-RT, the 5-year rates of LC, RC, MFI, DFI, DFS, and OS were 89%, 91.5%, 75.5%, 69%, 64.3%, and 83%, respectively. Factors associated with improved DFI included: endometrioid histology (p = 0.03), isolated vaginal relapse (p = 0.003), late recurrence (>9 months) [p = 0.007], and combined modality RT (p = 0.001). The only factor associated with OS was isolated vaginal relapse (in absence of other recurrent disease) [p = 0.02]. Regarding toxicity, 18% of patients experienced acute grade ≥3 events (most commonly gastrointestinal). The 5-year rates of rectal bleeding, small bowel obstruction, and pelvic fracture were 31%, 18%, and 13%, respectively. Salvage RT imparts excellent locoregional control for vaginal relapses of endometrial cancer, and should entail combination EBRT and VBT whenever feasible. However, distant progression is common among this population, and patients should be closely monitored for late gastrointestinal toxicity following salvage RT." @default.
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• W3093859425 date "2020-11-01" @default.
• W3093859425 modified "2023-10-14" @default.
• W3093859425 title "Outcomes and Toxicity following Salvage Radiotherapy for Vaginal Relapse of Endometrial Cancer" @default.
• W3093859425 doi "https://doi.org/10.1016/j.ijrobp.2020.07.1559" @default.
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