From February 2001 to May 2008, 122 patients with International Federation of Gynecology and Obstetrics Stage IaG3-IIIaG2 endometrial adenocarcinoma were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by postoperative IVBa. Seventy-seven patients (63.1 % ) underwent surgical staging. Total IVBa dose was 25 Gy in five consecutive daily fractions prescribed at 0.5-cm depth.
After a median followup of 4.1 years, the rates of Radiation Therapy Oncology Group Grades 1, 2, and ? complications were 12.9 % , 3.4 % , and 0.8 % , respectively. Five patients (4.1 % ) presented locoregional failures: two isolated nodal pelvic failures, one vaginal pelvic relapse (intra-abdominal lymph node metastases), one vaginal distant failure, and one combined locoregional and distant failure. The 8.5-year actuarial vaginal control rate was 97.5 % , and the pelvic control rate was 94.3 % . Six other patients developed distant metastases alone. The 8.5-year actuarial overall and disease-free survival rates were 90.3 % and 87.2 % , respectively. Univariate analysis revealed that?histologic grade, deep myometrial invasion, advanced age, and categorization as high intermediate-risk patient according to the PORTEC-2 and the Gynecologic Oncology Group (GOG)-99 stratifications were statistically significant prognostic factors. After multivariate analysis, histologic grade (p = 0.001) and high intermediate risk according to GOG-99 (p = 0.004) and PORTEC-2 (p = 0.001) remained significant.
The proposed scheme reproduces the excellent results obtained with more protracted schemes and has the added advantage of shortened overall treatment time.