Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/25895
Type: Artigo de periódico
Title: Adjuvant radiotherapy in early stage endometrial cancer
Title Alternative: Radioterapia adjuvante para câncer do endométrio estádio inicial
Author: Zuliani, Antonio Carlos
Cairo, Aurea Akemi
Esteves, Sérgio Carlos Barros
Watanabe, Carla Cristina dos Santos
Cunha, Maércio de Oliveira
Souza, Gustavo Antonio de
Abstract: OBJECTIVE: To compare the rates of overall survival (OS), disease-free survival (DFS) and toxicity in different techniques of postoperative radiotherapy for stage IA endometrioid adenocarcionoma of endometrium, histological grades 1and 2. METHODS: A historical comparison between treatment regimens was performed, and 133 women with a minimum follow-up of 5 years were included. Teletherapy (TELE group), with 22 patients treated from 1988 to 1996, with a 10 MV linear accelerator, average dose 46.2 Gy. Low dose rate brachytherapy (LDRB group) was performed between 1992 and 1995, in 19 women, with an insertion of Cesium 137, at a 60 Gy dose. Fourteen women operated between 1990 and 1996 did not receive radiotherapy (NO RT group). High dose rate brachytherapy was performed in 78 patients (HDRB group), from 1996 to 2004, in five weekly 7 Gy insertions, prescribed at 0.5 cm from the vaginal cylinder. RESULTS: The 5-year disease-free survival was 94.6% for the HDRB group, 94.1% for the LDRB group, 100% for the TELE group and NO RT groups (p = 0.681). The 5-year overall survival was 86.6% for the HDRB group, 89.5% for the LDRB group and 90% for the TELE group and NO RT groups (p = 0.962). Grades 3-5 late toxicity was 5.3% in LDRB group and 27.3% for the TELE group (p < 0.001). CONCLUSION: Patients submitted to adjuvant teletherapy showed very high toxicity, which contraindicates that treatment for those patients. There may be a role for adjuvant HDRB, but randomized controlled trials are still needed to evaluate its benefit.
OBJETIVO: Comparar as taxas de sobrevida global (SG), sobrevida livre de doença (DFS) e de toxicidade em diferentes técnicas de radioterapia pós-operatória para adenocarcionoma endometrioide do endométrio estádio IA, graus histológicos 1 e 2. MéTODOS: Realizou-se uma comparação histórica entre regimes de tratamento, incluindo 133 mulheres com seguimento mínimo de cinco anos. Teleterapia (grupo TELE), com 22 pacientes, de 1988 a 1996, tratadas com acelerador linear 10 MV, dose média de 46,2 Gy. Braquiterapia de baixa taxa de dose (grupo LDRB), realizada entre 1992 e 1995, em 19 mulheres, com uma inserção de Césio 137, dose de 60 Gy. Quatorze mulheres operadas entre 1990 e 1996 não receberam radioterapia (grupo NO RT). Braquiterapia de alta taxa de dose foi realizada em 78 pacientes (grupo BATD), 1996-2004, cinco inserções semanais de 7 Gy, a 0,5 cm do cilindro vaginal. RESULTADOS: A DFS em cinco anos foi de 94,6% para o grupo BATD, 94,1% para o grupo LDRB, 100% para os grupos TELE e RT (p = 0,681). A sobrevida global em cinco anos foi de 86,6% para o grupo BATD, 89,5% para o grupo LDRB e 90% para os grupos TELE e NO RT (p = 0,962). A toxicidade tardia graus 3-5 foi de 5,3% no grupo LDRB e 27,3% para o grupo TELE (p < 0,001). CONCLUSãO: Pacientes submetidos ?á teleterapia adjuvante apresentaram toxicidade muito elevada, o que contraindica o tratamento para essas pacientes. Pode haver um papel para a BATD adjuvante, mas estudos controlados randomizados são necessários para avaliar seu benefício.
Subject: Neoplasias dos genitais femininos
radioterapia adjuvante
braquiterapia
neoplasias do endom&#233;trio
Genital neoplasms, female
radiotherapy, adjuvant
brachytherapy
endometrial neoplasms
Editor: Associação Médica Brasileira
Rights: aberto
Identifier DOI: 10.1590/S0104-42302011000400019
Address: http://dx.doi.org/10.1590/S0104-42302011000400019
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302011000400019
Date Issue: 1-Aug-2011
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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