Decades After Endometrial Cancer

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Endometrial cancer radiotherapy techniques did not affect overall survival rates

September 10, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) Cancer of the endometrium, the lining of the uterus, is the most common female reproductive cancer. Fortunately, survival rates for endometrial cancer are outstanding. Recent research looked at how treatment affects the lifespan of endometrial cancer survivors.

After following endometrial cancer survivors for more than 20 years, researchers discovered that there was no difference in overall survival when comparing different types of radiation therapy used in the treatment of early stage endometrial cancer.

Among all the women studied, those who received internal radiation alone and those who also received external radiation lived a median (middle) of 20.5 years.

The study did find that women younger than 60 years old who had been treated with external radiation had higher risks of dying and developing second cancers compared to women who had only received internal radiotherapy.

"Talk to your doctor about the long-term effects of your cancer treatment."

Mathias Onsrud, MD, a physician and researcher at the Norwegian Radium Hospital of the Oslo University Hospital in Oslo, Norway, led this follow-up of a randomized study published in 1980.

The previous study conducted at the Norwegian Radium Hospital randomly assigned 568 women with early (stage l) endometrial cancer to receive either vaginal radium brachytherapy (VBT) followed by external beam radiation therapy (EBRT) or brachytherapy alone.

Vaginal brachytherapy involves inserting a cylinder filled with a radioactive substance — in this case radium — into the vagina. External beam radiation therapy involves targeting high-powered X-rays to the pelvic region.

Radiotherapy is performed after surgery to kill any remaining cancer cells.

Participants in this study had all had surgery to remove the uterus and cervix, along with the ovaries and fallopian tubes.

A total of 288 women in this study received VBT and EBRT, while 280 received brachytherapy alone.

After a median follow-up of 20.5 years, the researchers found the following:

  • Median survival rate for women in the EBRT group was 20.50 years and 20.48 years in the VBT group.
  • Women in the EBRT group who were younger than 60 at the time of treatment had a 36 percent higher mortality (death) rate than did the women who received only brachytherapy.
  • Women under the age of 60 who had EBRT had two times greater risks of developing second cancers than did women who had VRT only — 39.7 percent versus 25.6 percent respectively.

Based on these findings, the authors concluded, “Adjuvant [after surgery] EBRT should be used with caution, especially in women with a long life expectancy.”

Brian D. Lawenda, MD, clinical director of Radiation Oncology at 21st Century Oncology in Las Vegas and founder of IntegrativeOncology-Essentials.com, told dailyRx News, “This study will add further reassurance that the use of a highly focused radiation treatment with minimal side effects and lower risk of secondary malignancies provides survival benefits equivalent to a more extensive radiation technique in the vast majority of patients with early stage endometrial cancer."

This study was published September 9 in the Journal of Clinical Oncology.

No outside funding was reported, and no author disclosed any potential conflicts of interest.