Preoperative irradiation for carcinoma of the endometrium: Indications and results

• Published in: Gynecologic oncology Vol. 5; no. 1; pp. 18 - 26
• Main Authors: Tak, Won K., Marchant, Douglas J., Munzenrider, John E., Anderson, Barrie
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.1977
• Subjects: Carcinoma - diagnostic imaging; Carcinoma - mortality; Carcinoma - radiotherapy; Carcinoma - surgery; Female; Follow-Up Studies; Humans; Hysterectomy; Middle Aged; Preoperative Care; Radiography; Radiotherapy Dosage; Uterine Neoplasms - diagnostic imaging; Uterine Neoplasms - mortality; Uterine Neoplasms - radiotherapy; Uterine Neoplasms - surgery
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/0090-8258(77)90003-8

One hundred thirty patients with carcinoma of the endometrium were treated preoperatively with external irradiation (4000 rad) and radium application (2500 mg/hr or 2000 rad). Criteria for preoperative irradiation included: large uterus [19], signs of myometrial invasion on hysterogram [50], cervical involvement [37], poorly differentiated or anaplastic carcinoma [13], adenosquamous cell carcinoma [10], or squamous cell carcinoma [1]. Hysterography was performed as part of the pretreatment work-up in 93 patients (71%). Diffuse, multiple or single large defects were observed in the fundus in 72%, 8% had defects in the lower uterine segment, and the remaining 20% showed no gross defects on hysterography. Eighty-seven (67%) had no residual tumor in the hysterectomy specimen, while residual carcinoma was seen in forty-three (33%). No local recurrence has developed in the pelvis or vagina. Six patients have developed extra-pelvic metastasis, and four have died of disease. Overall survival is 97% with follow-up of 1 to 6 years.