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Title: Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement

Abstract

Purpose: To evaluate the survival benefit of adding vaginal brachytherapy (BT) to pelvic external beam radiation therapy (EBRT) in women with stage III endometrial cancer. Methods and Materials: The National Cancer Data Base was used to identify patients with stage III endometrial cancer from 2004 to 2013. Only women who received adjuvant EBRT were analyzed. Women were grouped according to receipt of BT. Logistic regression modeling was used to identify predictors of receiving BT. Log–rank statistics were used to compare survival outcomes. Cox proportional hazards modeling was used to evaluate the effect of BT on survival. A propensity score–matched analysis was also conducted among women with cervical involvement. Results: We evaluated 12,988 patients with stage III endometrial carcinoma, 39% of whom received EBRT plus BT. Women who received BT were more likely to have endocervical or cervical stromal involvement (odds ratios 2.03 and 1.77; P<.01, respectively). For patients receiving EBRT alone, the 5-year survival was 66% versus 69% with the addition of BT at 5 years (P<.01). Brachytherapy remained significantly predictive of decreased risk of death (hazard ratio 0.86; P<.01) on multivariate Cox regression. The addition of BT to EBRT did not affect survival among women without cervical involvement (P=.84). Formore » women with endocervical or cervical stromal invasion, the addition of BT significantly improved survival (log–rank P<.01). Receipt of EBRT plus BT was associated with improved survival in women with positive and negative surgical margins, and receiving chemotherapy did not alter the benefit of BT. Propensity score–matched analysis results confirmed the benefit of BT among women with cervical involvement (hazard ratio 0.80; P=.01). Conclusions: In this population of women with stage III endometrial cancer the addition of BT to EBRT was associated with an improvement in survival for women with endocervical or cervical stromal invasion.« less

Authors:
 [1]; ;  [2];  [3]; ;  [2];  [2]
  1. Department of Radiation Oncology, Vanderbilt University, Nashville, Tennessee (United States)
  2. Department of Radiation Oncology, University of Utah, Salt Lake City, Utah (United States)
  3. Division of Epidemiology, University of Utah, Salt Lake City, Utah (United States)
Publication Date:
OSTI Identifier:
22649894
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 97; Journal Issue: 5; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; CHEMOTHERAPY; EXTERNAL BEAM RADIATION THERAPY; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; WOMEN

Citation Formats

Bingham, Brian, Orton, Andrew, Boothe, Dustin, Stoddard, Greg, Huang, Y. Jessica, Gaffney, David K., and Poppe, Matthew M., E-mail: Matthew.poppe@hci.utah.edu. Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2016.12.035.
Bingham, Brian, Orton, Andrew, Boothe, Dustin, Stoddard, Greg, Huang, Y. Jessica, Gaffney, David K., & Poppe, Matthew M., E-mail: Matthew.poppe@hci.utah.edu. Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement. United States. doi:10.1016/J.IJROBP.2016.12.035.
Bingham, Brian, Orton, Andrew, Boothe, Dustin, Stoddard, Greg, Huang, Y. Jessica, Gaffney, David K., and Poppe, Matthew M., E-mail: Matthew.poppe@hci.utah.edu. Sat . "Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement". United States. doi:10.1016/J.IJROBP.2016.12.035.
@article{osti_22649894,
title = {Brachytherapy Improves Survival in Stage III Endometrial Cancer With Cervical Involvement},
author = {Bingham, Brian and Orton, Andrew and Boothe, Dustin and Stoddard, Greg and Huang, Y. Jessica and Gaffney, David K. and Poppe, Matthew M., E-mail: Matthew.poppe@hci.utah.edu},
abstractNote = {Purpose: To evaluate the survival benefit of adding vaginal brachytherapy (BT) to pelvic external beam radiation therapy (EBRT) in women with stage III endometrial cancer. Methods and Materials: The National Cancer Data Base was used to identify patients with stage III endometrial cancer from 2004 to 2013. Only women who received adjuvant EBRT were analyzed. Women were grouped according to receipt of BT. Logistic regression modeling was used to identify predictors of receiving BT. Log–rank statistics were used to compare survival outcomes. Cox proportional hazards modeling was used to evaluate the effect of BT on survival. A propensity score–matched analysis was also conducted among women with cervical involvement. Results: We evaluated 12,988 patients with stage III endometrial carcinoma, 39% of whom received EBRT plus BT. Women who received BT were more likely to have endocervical or cervical stromal involvement (odds ratios 2.03 and 1.77; P<.01, respectively). For patients receiving EBRT alone, the 5-year survival was 66% versus 69% with the addition of BT at 5 years (P<.01). Brachytherapy remained significantly predictive of decreased risk of death (hazard ratio 0.86; P<.01) on multivariate Cox regression. The addition of BT to EBRT did not affect survival among women without cervical involvement (P=.84). For women with endocervical or cervical stromal invasion, the addition of BT significantly improved survival (log–rank P<.01). Receipt of EBRT plus BT was associated with improved survival in women with positive and negative surgical margins, and receiving chemotherapy did not alter the benefit of BT. Propensity score–matched analysis results confirmed the benefit of BT among women with cervical involvement (hazard ratio 0.80; P=.01). Conclusions: In this population of women with stage III endometrial cancer the addition of BT to EBRT was associated with an improvement in survival for women with endocervical or cervical stromal invasion.},
doi = {10.1016/J.IJROBP.2016.12.035},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 97,
place = {United States},
year = {Sat Apr 01 00:00:00 EDT 2017},
month = {Sat Apr 01 00:00:00 EDT 2017}
}