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Objective.To determine the efficacy of high-dose rate brachytherapy as adjuva nt treatment for Stage Ⅰ/Ⅱpapillary serous or clear cell endometrial cancer. M ethods. A retrospective study of all patients with Stage Ⅰ/Ⅱpapillary serous o r clear cell endometrial cancer treated with high-dose rate brachytherapy betwe en 1995 and 2001 was performed. Following surgical staging, which included hyste rectomy with pelvic and aortic lymphadenectomy, all patients without extrauterin e disease were treatedwith high-dose rate brachytherapy and followed for recurr ence. The locations of recurrences were noted and were classified as local or di stant. Results. Three (13%) recurrences occurred among 24 patients with Stage Ⅰ/Ⅱpapillary serous or clear cell carcinoma. The risk of recurrence was simila r for papillary serous and clear cell cancer (12%vs. 12%). Local control was a chieved in 96%. The risk of recurrence for those with no myometrial invasion, l ess than 1/2, or more than 1/2 myometrial invasion was 0%, 10%, and 50%, resp ectively (P < 0.04). Two of the three recurrences were distant and all patients with recurrence died despite additional treatment. Conclusions. High-dose rate brachytherapy (HDR) as the sole adjuvant treatment of Stage Ⅰ/Ⅱpapillary serou s or clear cell carcinoma is associated with a 13%risk of recurrence. Although local control with HDR is excellent, the risk of distant recurrence is increased with deep myometrial invasion. Highdose rate brachytherapy is adequate for Stag e IA cases, but more aggressive treatment combining chemotherapy with HDR should be evaluated for more advanced Stage Ⅰ/Ⅱcases.
Objective.To determine the efficacy of high-dose rate brachytherapy as adjuva nt treatment for Stage Ⅰ / Ⅱpapillary serous or clear cell endometrial cancer. M ethods. A retrospective study of all patients with Stage Ⅰ / Ⅱpapillary serous or clear cell endometrial cancer treated with high-dose rate brachytherapy betwe en 1995 and 2001 was performed. which include hysterectomy with pelvic and aortic lymphadenectomy, all patients without extrauterin e disease were treated with high-dose rate brachytherapy and followed for recurrence. The locations of recurrences were (13%) recurrences occurred among 24 patients with Stage Ⅰ / Ⅱpapillary serous or clear cell carcinoma. The risk of recurrence was simila r for papillary serous and clear cell cancer (12 % vs. 12%). Local control was a chieved in 96%. The risk of recurrence for those with no myometrial invasion, lssss 1/2, or more than 1/2 my Two of the three recurrences were distant and all patients with survrence died despite additional treatment. Conclusions. High-dose rate brachytherapy (HDR) as the sole adjuvant treatment of Stage Ⅰ / Ⅱpapillary serouse or clear cell carcinoma is associated with a 13% risk of recurrence. Although local control with HDR is excellent, the risk of distant recurrence is increased with deep myometrial invasion. Highdose rate brachytherapy is adequate for Stag e IA cases, but more aggressive treatment combining chemotherapy with HDR should be evaluated for more advanced Stage I / IIcases.