FIFTEEN-YEAR RADIOTHERAPY OUTCOMES OF THE RANDOMIZED PORTEC-1 TRIAL FOR ENDOMETRIAL CARCINOMA

被引：261

作者：

Creutzberg, Carien L. ^{[1
]}

Nout, Remi A. ^{[1
]}

Lybeert, Marnix L. M. ^{[2
]}

Warlam-Rodenhuis, Carla C. ^{[3
]}

Jobsen, Jan J. ^{[4
]}

Mens, Jan-Willem M. ^{[5
]}

Lutgens, Ludy C. H. W. ^{[7
]}

Pras, Elisabeth ^{[8
]}

van de Poll-Franse, Lonneke V. ^{[9
,10
]}

van Putten, Wim L. J. ^{[6
]}

机构：

[1] Leiden Univ, Dept Clin Oncol, Med Ctr, NL-2300 RC Leiden, Netherlands

[2] Catharina Hosp, Dept Radiotherapy, Eindhoven, Netherlands

[3] Univ Med Ctr Utrecht, Dept Radiat Oncol, Utrecht, Netherlands

[4] Medisch Spectrum Twente, Dept Radiotherapy, Enschede, Netherlands

[5] ErasmusMC Daniel Hoed Canc Ctr, Dept Radiat Oncol, Rotterdam, Netherlands

[6] ErasmusMC Daniel Hoed Canc Ctr, Dept Biostat, Rotterdam, Netherlands

[7] MAASTRO Clin, Maastricht, Netherlands

[8] Univ Groningen, Univ Med Ctr Groningen, Dept Radiotherapy, Groningen, Netherlands

[9] Tilburg Univ, Comprehens Canc Ctr S, Eindhoven, Netherlands

[10] Tilburg Univ, Ctr Res Psychol Somat Dis, Eindhoven, Netherlands

来源：

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2011年 / 81卷 / 04期

关键词：

Endometrial carcinoma; Long-term outcome; Randomized trial; Radiation therapy; Prognostic factors; LYMPHVASCULAR SPACE INVOLVEMENT; EXTERNAL-BEAM RADIOTHERAPY; CANCER MRC ASTEC; QUALITY-OF-LIFE; PHASE-III TRIAL; POSTOPERATIVE RADIOTHERAPY; ADJUVANT CHEMOTHERAPY; PELVIC RADIOTHERAPY; INTERMEDIATE-RISK; VAGINAL BRACHYTHERAPY;

D O I：

10.1016/j.ijrobp.2011.04.013

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: To evaluate the very long-term results of the randomized Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-1 trial for patients with Stage I endometrial carcinoma (EC), focusing on the role of prognostic factors for treatment selection and the long-term risk of second cancers. Patients and Methods: The PORTEC trial (1990-1997) included 714 patients with Stage IC Grade 1-2 or Stage IB Grade 2-3 EC. After surgery, patients were randomly allocated to external-beam pelvic radiotherapy (EBRT) or no additional treatment (NAT). Analysis was by intention to treat. Results: 426 patients were alive at the date of analysis. The median follow-up time was 13.3 years. The 15-year actuarial locoregional recurrence (LRR) rates were 6% for EBRT vs. 15.5% for NAT (p < 0.0001). The 15-year overall survival was 52% vs. 60% (p = 0.14), and the failure-free survival was 50% vs. 54% (p = 0.94). For patients with high-intermediate risk criteria, the 15-year overall survival was 41% vs. 48% (p = 0.51), and the 15-year EC-related death was 14% vs. 13%. Most LRR in the NAT group were vaginal recurrences (11.0% of 15.5%). The 15-year rates of distant metastases were 9% vs. 7% (p = 0.25). Second primary cancers had been diagnosed over 15 years in 19% of all patients, 22% vs. 16% for EBRT vs. NAT (p = 0.10), with observed vs. expected ratios of 1.6 (EBRT) and 1.2 (NAT) compared with a matched population (p = NS). Multivariate analysis confirmed the prognostic significance of Grade 3 for LRR (hazard ratio [HR] 3.4, p = 0.0003) and for EC death (HR 7.3, p < 0.0001), of age > 60 (HR 3.9, p = 0.002 for LRR and 2.7, p = 0.01 for EC death) and myometrial invasion > 50% (HR 1.9, p = 0.03 and HR 1.9, p = 0.02). Conclusions: The 15-year outcomes of PORTEC-1 confirm the relevance of HIR criteria for treatment selection, and a trend for long-term risk of second cancers. EBRT should be avoided in patients with low-and intermediate-risk EC. (C) 2011 Elsevier Inc.

引用

页码：E631 / E638

页数：8

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