Pretrospective study of prognostic factors in patients with endometrial cancer treated with adjuvant radiotherapy

Introduction and Purpose: Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women. The incidence of endometrial cancers in women is % 6. In this study it was aimed to investigate the effects of the prognostic factors related to tumor, treatment and patient on local and regional control, overall survival and disease free survival. Material and Method: Sixty one patients patients who admitted to İnönü University Radiation Oncology Department between December 2003 and December 2011 suffering from adenocarcinom of endometrium after surgical operation and adjuvant radiotherapy and brachytherapy were analyzed retrospectively. The age of the patients, differentiation, stage and lymphovascular, serozal, adnex, myometrial, endoservikal invasion, lymph node metastasis, hypertension, diabetes, hormon replacement therapy, concurrent chemotherapy application, smoking, number of births, age of menopause, vaginal brachitherapy, radiotherapy modality and doses were assessed. Results: The median age was 59 (36-82) . There were 30 patients (49 %) aged over 60 and 31 patients (51 %) under 60. Two patients (3.6 %) under 40. In the histopathologic analysis of the tumor differentiation; 7 patients Grade1 ( 11.5 %), 25 patients Grade 2 (41 %), 27 patients Grade3-4 (44.3 %). Twenty six patients (42 %) were in Stage III, 6 patients ( 10%) stage 2 and 29 patients ( 48%) stage 1. Fifty three patiens (87 %) were exposure TAH+BSO+BPLND, 8 patients ( 13 %) were exposure TAH-BSO. Thirty patients were treated by conventional methods, 23 patients were treated by conformal methods. Eight patients were treated by only brachytherapy. All patients received about 4500-5040 cGy external radiotherapy. Spinal cord doses under 4600 cGy. Fraction doses were 180 or 200 cGy. Paraaortik radioterapy doses were 4600 cGy. 16 patients (26.2 %) had adjuvant chemotherapy, 3 patients ( 5 %) had chemotherapy when metastasis and recurrens, 4 patients ( 6.6 %) had adjuvant + when metastasis and recurrens chemotherapy. 41 patients (67 %) haven?t lenfatic nodal involment. Six patients (10 %) have pelvic nodal involment, 4 patients ( 6.6 %) have paraaortic nodal involment and 10 patients ( 16.4 %) have pelvic + paraaortic nodal involment. Conclusion: The five year overall survival was 80.3% and disease free survival was found as 77 %. Two year overall survival 93.4 % and disease free survival was found as 85.2 %. It was noticed that serozal invasion (p=0.034), metastasis (p<0.0001), paraaortic radiotherapy (p=0.001) , Cheomotherapy (p=0.003) and local recurrens (p=0.001) had importance on overall survival. But were not important for disease free survival. Brachytherapy successful on local control (p<0.001)