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Pelvic Radiation Recommended for Early Endometrial Cancer

By MedImaging International staff writers
Posted on 12 Oct 2017

Image: A new study confirms pelvic external beam therapy is preferred for treating endometrial cancer (Photo courtesy of Wikimedia).

A new study confirms that radiation alone offers better pelvic control and fewer severe side effects than a combination of brachytherapy and chemotherapy in women with early high-risk endometrial cancer.

Researchers at the University of Kentucky (UKY; Lexington, USA), Memorial Sloan-Kettering Cancer Center (MSKCC; New York, NY, USA), and other institutions conducted a phase III trial involving 601 women (mean age 63) with stage I endometrioid histology and high intermediate risk to determine if vaginal cuff brachytherapy and chemotherapy (VCB/C) could increase recurrence-free survival, compared to pelvic external beam radiation therapy (PXRT). Secondary objectives included comparisons of overall survival (OS), patterns of failure, and frequency/severity of adverse events.

In all, 301 patients were assigned to PXRT and 300 to VCB/C; 74% had stage I disease, and 89% underwent lymphadenectomy. The results revealed that acute toxicity was more common and more severe with VCB/C, with grade 3 or higher adverse events reported in 32 patients on the PXRT arm, compared to 187 patients on the VCB/C arm. With a median follow-up of 53 months, the 36 month OS was 91% for PXRT, versus 88% for VCB/C. While no significant differences were noted between the two arms in terms of vaginal or distant failure, pelvic or para-aortic nodal recurrences were significantly more common in the VCB/C arm. The study was presented at the 59th annual meeting of the American Society for Radiation Oncology (ASTRO), held during September 2017 in San Diego (CA, USA).

“Previous Gynecology Oncology Group trials confirmed that pelvic radiation is an effective, safe, and tolerable option to manage early-stage endometrial cancer,” said lead author Professor Marcus Randall, MD, of UKY. “The current trial confirms that this standard treatment is preferable to the experimental approach of vaginal cuff brachytherapy followed by chemotherapy, in terms of tumor control in the nodal regions and also in terms of acute toxicity. This finding holds true even for patients at a higher risk of recurrence.”

Endometrial cancer begins in endometrium, a layer of cells that form the lining of the uterus. It is often detected at an early stage since it frequently produces abnormal vaginal bleeding. Risk factors include hormonal imbalance (estrogen versus progesterone); irregular ovulation patterns; early menstruation; never having been pregnant; old age; obesity; tamoxifen hormone therapy for breast cancer; and hereditary nonpolyposis colorectal cancer (HNPCC), a syndrome that increases the risk of colon cancer and other cancers, including endometrial cancer. If discovered early enough, a hysterectomy often cures endometrial cancer.

Related Links:
University of Kentucky
Memorial Sloan-Kettering Cancer Center

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68 (33.855438232422): SELECT fid FROM jos_deeppockets WHERE id=294771091 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294771091 AND published='1' LIMIT 1

69 (41.961669921875): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

70 (288.00964355469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (285.14862060547): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (53.882598876953): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (69.141387939453): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (47.206878662109): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (61.03515625): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (62.942504882812): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (34.093856811523): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (76.055526733398): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (96.797943115234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

105 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

106 (82.015991210938): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294771091 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (66.041946411133): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294771091 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

109 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

110 (77.962875366211): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294771091 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (684.97657775879): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294771091 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (629.18663024902): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (476.83715820312): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (85.115432739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

115 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

116 (170.94612121582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

117 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

118 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

119 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

120 (311.85150146484): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 23227.93006897): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (137.0906829834): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

123 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

124 (492.09594726562): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294771091 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294771091 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 786165.9526825): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 1723397.0165253): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 4487.9913330078): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (!!!!! 4013.0615234375): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (!!!!! 3722.9061126709): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (938.89236450195): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (634.90867614746): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (!!!!! 4137.9928588867): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (526.18980407715): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (489.95018005371): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (336.88545227051): SELECT name FROM jos_deeppockets WHERE id=213

136 (668.04885864258): SELECT name FROM jos_deeppockets WHERE id=213

137 (764.13154602051): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (!!!!! 1960.0391387939): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 18635.034561157): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

140 (96.797943115234): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

141 (!!!!! 28373.003005981): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 3419.8760986328): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294771091 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (619.17304992676): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294771091 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (688.07601928711): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (229.83551025391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

147 (223.87504577637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

148 (!!!!! 1979.1126251221): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (463.00888061523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

150 (238.18016052246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

151 (!!!!! 1991.9872283936): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294771091 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294771091 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (198.8410949707): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

153 (!!!!! 7129.9076080322): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

154 (!!!!! 7557.1537017822): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 7711.8873596191): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

156 (392.19856262207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294771091 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294771091 AND published='1' LIMIT 1

157 (38.14697265625): select jos_twitters.link from jos_twitters where cat=10

158 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

159 (25.98762512207): select jos_google_plus.link from jos_google_plus where cat=10

160 (277.04238891602): select jos_linkedin.link from jos_linkedin where cat=10

161 (389.09912109375): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 6880.9986114502): insert into jos_banners_delta values (14615,'2025-06-17 02:14:14','216.73.216.120','view'),(14202,'2025-06-17 02:14:14','216.73.216.120','view'),(14203,'2025-06-17 02:14:14','216.73.216.120','view')

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