Endometrial kanserin tedavisinde postoperatif radyoterapi: 158 hastanın gözden geçirilmesi

Öz

Amaç: Endometrial kanser, Batı'da en sık görülen jinekolojik kanserdir. Göğüs ve bağırsaktan sonraki üçüncü kadın kanseridir. Esas olarak menopozdaki kadınlarla ilgilidir. Amacımız, retrospektif bir çalışma ve literatür verileri ışığında, bu kanserin yönetiminde radyoterapinin rolünü vurgulamaktır.

Yöntemler: Ocak 2012 ile Aralık 2016 arasında 5 yıllık bir süre için FEZ'nin üniversite hastanesinde radyoterapi bölümünde hastaların endometriyal kayıtları ile ilgili retrospektif bir kohort çalışmasıdır.

Bulgular: Yaş ortalaması 64 olan (36-92 yaş arası) 158 hasta topladık, tüm hastaların histerektomi (olguların %76'sı) veya (olguların %24'ü) ganglion diseksiyonu yoktu. Tip 1 en sık görülen histolojik tipti (olguların %96'sı). Olguların %51'inde miyometriyal invazyon %50'den, vakaların %36'sında histolojik derece III ve %16'sında servikal invazyon görülmüştür. Terapötik olarak, hastaların %18'i konvansiyonel fraksiyonasyon ve yaymada 50 Gy'lik bir dozda özel eksternal radyoterapi aldı, 46 Gy dozunda bir TEN, %58'inde brakiterapi barajı ve hastaların sadece %24'ü brakiterapi aldı.

Ortalama 25 aylık takipten sonra hastaların %91'i iyi lokal kontrolde, %9'unda uzak metastaz vardı.

Sonuç: Radyoterapi, yüksek endometriyal kanserlerin terapötik stratejisinde veya istenmeyen histolojik karakterlerde önemli bir yer tutmaktadır ve bu nedenle lokal nüks oranlarının azaltılmasına izin vermektedir.

Anahtar Kelimeler

• Endometrium,Kanser,Cerrahi,Radyoterapi

Postoperative radiotherapy in the treatment of endometrial cancer: Review of 158 patients

Abstract

Aim: Endometrial cancer is the most common gynecological cancer in the West. It is the third cancer of women after that of the breast and intestine. It mainly concerns menopausal women. Our aim is to highlight, through a retrospective study and in light of literature data, the role of radiotherapy in the management of this cancer.

Methods: This is a retrospective cohort study concerning patients' records for endometrial in the radiotherapy department at university hospital center of FEZ for a period of 5 years from January 2012 to December 2016.

Results: We collected 158 patients of mean age 64 years (36 to 92 years), all patients had a total hysterectomy with (76% of cases) or without (24% of cases) ganglion dissection. Type 1 was the most common histological type (96% of cases). The myometrial invasion was greater than 50% in 51% of cases, histological grade III in 36% of cases, and cervical invasion was observed in 16% of cases. Therapeutically, 18% of patients received exclusive external radiotherapy at a dose of 50 Gy in conventional fractionation and spreading, a TEN at a dose of 46 Gy followed by a brachytherapy dam in 58% of cases, and 24% of patients received brachytherapy alone.

After an average follow-up of 25 months, 91% of the patients are in good locoregional control, 9% of the patients had distant metastases.

Conclusion: Radiotherapy retains an important place in the therapeutic strategy of high endometrial cancers, or with unfavorable histological characters, and thus allows the reduction of locoregional recurrence rates.

Keywords

• Endometrium,Cancer,Surgery,Radiotherapy

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