Objective To analyze the result of intensity modulated radiation therapy(IMRT)in recurrent endometrial carcinoma and its influence factors.
Methods Fourty cases of patients with endometrial cancer in our hospital from September,2012 to October,2013 were treated with IMRT for regionally pelvic or paraortic nodal recurrences.Compare FIGO stage,number of recurrent sites,size of largest recurrent node,lymph node dissection,histology and grade characteristics according to the types of chemotherapy.Survival rate was calculated by Kaplan-Meier method.
Results Fourteen (35%) initially received chemotherapy and 22(55%) received concurrent chemotherapy.FIGO stage:Ⅰ/Ⅱ of 21 cases,Ⅲ/Ⅳ of 19 cases. Number of recurrent sites:15 cases of single site,25 cases of multiple sites.Tumor diameter:23 cases <3 cm diameter,17 cases ≥ 3 cm. Lymphatic stromal invasion:13 cases of pelvic nodal recurrences,8 cases of paraortic recurrences only,19 cases of simultaneous pelvic and paraortic recurrences.Pathological:31 cases of adenocarcinoma,clear-cell carcinoma in 3 cases,3 cases of adenosquamous carcinoma,3 cases of serous adenocarcinoma.Histological grade:7 cases of poorly differentiated,22 cases of intermediate differentiated,11 cases of well-differentiated. No different clinical characteristics observed between patients treated with and without chemotherapy(
P>0.05).The 2 year survival rate was 72.5%.Patients undergoing initial chemotherapy prior to IMRT had shorter survival rate(
P=0.043).Patients receiving concurrent chemotherapy had significantly longer survival rate(
P=0.045).
Conclusion Concurrent chemotherapy with IMRT can improve survival time in patients with recurrent endometrial cancer. Initially chemotherapy is not beneficial to survival rate.