Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma
Purpose To evaluate the very long-term results of the randomized Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-1 trial for patients with Stage I endometrial carcinoma (EC), focusing on the role of prognostic factors for treatment selection and the long-term risk of second cancer...
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| creator | Creutzberg, Carien L., M.D., Ph.D Nout, Remi A., M.D Lybeert, Marnix L.M., M.D Wárlám-Rodenhuis, Carla C., M.D Jobsen, Jan J., M.D., Ph.D Mens, Jan-Willem M., M.D Lutgens, Ludy C.H.W., M.D., Ph.D Pras, Elisabeth, M.D., Ph.D van de Poll-Franse, Lonneke V., Ph.D van Putten, Wim L.J., M.Sc |
| description | Purpose To evaluate the very long-term results of the randomized Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-1 trial for patients with Stage I endometrial carcinoma (EC), focusing on the role of prognostic factors for treatment selection and the long-term risk of second cancers. Patients and Methods The PORTEC trial (1990–1997) included 714 patients with Stage IC Grade 1–2 or Stage IB Grade 2–3 EC. After surgery, patients were randomly allocated to external-beam pelvic radiotherapy (EBRT) or no additional treatment (NAT). Analysis was by intention to treat. Results 426 patients were alive at the date of analysis. The median follow-up time was 13.3 years. The 15-year actuarial locoregional recurrence (LRR) rates were 6% for EBRT vs. 15.5% for NAT ( p < 0.0001). The 15-year overall survival was 52% vs. 60% ( p = 0.14), and the failure-free survival was 50% vs. 54% ( p = 0.94). For patients with high-intermediate risk criteria, the 15-year overall survival was 41% vs. 48% ( p = 0.51), and the 15-year EC-related death was 14% vs. 13%. Most LRR in the NAT group were vaginal recurrences (11.0% of 15.5%). The 15-year rates of distant metastases were 9% vs. 7% ( p = 0.25). Second primary cancers had been diagnosed over 15 years in 19% of all patients, 22% vs. 16% for EBRT vs. NAT ( p = 0.10), with observed vs. expected ratios of 1.6 (EBRT) and 1.2 (NAT) compared with a matched population ( p = NS). Multivariate analysis confirmed the prognostic significance of Grade 3 for LRR (hazard ratio [HR] 3.4, p = 0.0003) and for EC death (HR 7.3, p < 0.0001), of age >60 (HR 3.9, p = 0.002 for LRR and 2.7, p = 0.01 for EC death) and myometrial invasion >50% (HR 1.9, p = 0.03 and HR 1.9, p = 0.02). Conclusions The 15-year outcomes of PORTEC-1 confirm the relevance of HIR criteria for treatment selection, and a trend for long-term risk of second cancers. EBRT should be avoided in patients with low- and intermediate-risk EC. |
| doi_str_mv | 10.1016/j.ijrobp.2011.04.013 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22054442</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S036030161100530X</els_id><sourcerecordid>1687663324</sourcerecordid><originalsourceid>FETCH-LOGICAL-c589t-2c88846462f52db69d2d90c843070ec7183cec82af947e67f67ebb312601b8583</originalsourceid><addsrcrecordid>eNqFkk2L1EAQhoMo7rj6D0QCHvSSWP2RTuciyDC7Cgsj6wjrQZpOp8J2TNJjdyLM_no7ZvXgQU9NdT1VL1VvJclzAjkBIt50ue28q485BUJy4DkQ9iDZEFlWGSuKm4fJBpiAjEX4LHkSQgcQyZI_Ts4oERwKCpvk64VtJ8Qx-4Lap9e6sW66Ra-Pp3Q_T8YNGFLXpvEvJsfGDfYOm_Tj_vqw22YkPXir-7R1Pt0tSZx-xVvtjR3doJ8mj1rdB3x2_54nny92h-377Gp_-WH77iozhaymjBopJRdc0LagTS2qhjYVGMkZlICmJJIZNJLqtuIlirIVJdY1I1QAqWUh2Xnycu3rwmRVMHZCc2vcOKKZFKVQcM5ppF6t1NG77zOGSQ02GOx7PaKbg6riBqGoqiKSr_9JEiFLIRijPKJ8RY13IXhs1dHbQfuTIqAWo1SnVqPUYpQCrqJMLHtxrzDXAzZ_in47E4G3K4Bxbz8s-mUsHA021i9TNc7-T-HvBqa3ozW6_4YnDJ2b_Rg9UUQFqkB9Wo5luRVCAAoGN-wn6FS4Uw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1687663324</pqid></control><display><type>article</type><title>Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Creutzberg, Carien L., M.D., Ph.D ; Nout, Remi A., M.D ; Lybeert, Marnix L.M., M.D ; Wárlám-Rodenhuis, Carla C., M.D ; Jobsen, Jan J., M.D., Ph.D ; Mens, Jan-Willem M., M.D ; Lutgens, Ludy C.H.W., M.D., Ph.D ; Pras, Elisabeth, M.D., Ph.D ; van de Poll-Franse, Lonneke V., Ph.D ; van Putten, Wim L.J., M.Sc</creator><creatorcontrib>Creutzberg, Carien L., M.D., Ph.D ; Nout, Remi A., M.D ; Lybeert, Marnix L.M., M.D ; Wárlám-Rodenhuis, Carla C., M.D ; Jobsen, Jan J., M.D., Ph.D ; Mens, Jan-Willem M., M.D ; Lutgens, Ludy C.H.W., M.D., Ph.D ; Pras, Elisabeth, M.D., Ph.D ; van de Poll-Franse, Lonneke V., Ph.D ; van Putten, Wim L.J., M.Sc ; PORTEC Study Group</creatorcontrib><description>Purpose To evaluate the very long-term results of the randomized Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-1 trial for patients with Stage I endometrial carcinoma (EC), focusing on the role of prognostic factors for treatment selection and the long-term risk of second cancers. Patients and Methods The PORTEC trial (1990–1997) included 714 patients with Stage IC Grade 1–2 or Stage IB Grade 2–3 EC. After surgery, patients were randomly allocated to external-beam pelvic radiotherapy (EBRT) or no additional treatment (NAT). Analysis was by intention to treat. Results 426 patients were alive at the date of analysis. The median follow-up time was 13.3 years. The 15-year actuarial locoregional recurrence (LRR) rates were 6% for EBRT vs. 15.5% for NAT ( p < 0.0001). The 15-year overall survival was 52% vs. 60% ( p = 0.14), and the failure-free survival was 50% vs. 54% ( p = 0.94). For patients with high-intermediate risk criteria, the 15-year overall survival was 41% vs. 48% ( p = 0.51), and the 15-year EC-related death was 14% vs. 13%. Most LRR in the NAT group were vaginal recurrences (11.0% of 15.5%). The 15-year rates of distant metastases were 9% vs. 7% ( p = 0.25). Second primary cancers had been diagnosed over 15 years in 19% of all patients, 22% vs. 16% for EBRT vs. NAT ( p = 0.10), with observed vs. expected ratios of 1.6 (EBRT) and 1.2 (NAT) compared with a matched population ( p = NS). Multivariate analysis confirmed the prognostic significance of Grade 3 for LRR (hazard ratio [HR] 3.4, p = 0.0003) and for EC death (HR 7.3, p < 0.0001), of age >60 (HR 3.9, p = 0.002 for LRR and 2.7, p = 0.01 for EC death) and myometrial invasion >50% (HR 1.9, p = 0.03 and HR 1.9, p = 0.02). Conclusions The 15-year outcomes of PORTEC-1 confirm the relevance of HIR criteria for treatment selection, and a trend for long-term risk of second cancers. EBRT should be avoided in patients with low- and intermediate-risk EC.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2011.04.013</identifier><identifier>PMID: 21640520</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; BEAMS ; Breast Neoplasms - epidemiology ; CARCINOMAS ; DEATH ; Disease-Free Survival ; Endometrial carcinoma ; Endometrial Neoplasms - mortality ; Endometrial Neoplasms - pathology ; Endometrial Neoplasms - radiotherapy ; Endometrial Neoplasms - surgery ; FAILURES ; Female ; FOCUSING ; HAZARDS ; Hematology, Oncology and Palliative Medicine ; Humans ; Long-term outcome ; METASTASES ; Middle Aged ; MULTIVARIATE ANALYSIS ; Neoplasm Grading ; Neoplasm Recurrence, Local - mortality ; Neoplasms, Second Primary - epidemiology ; PATIENTS ; Prognosis ; Prognostic factors ; Radiation therapy ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Randomized trial ; Risk ; SURGERY ; Treatment Outcome ; Vaginal Neoplasms - secondary</subject><ispartof>International journal of radiation oncology, biology, physics, 2011-11, Vol.81 (4), p.e631-e638</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c589t-2c88846462f52db69d2d90c843070ec7183cec82af947e67f67ebb312601b8583</citedby><cites>FETCH-LOGICAL-c589t-2c88846462f52db69d2d90c843070ec7183cec82af947e67f67ebb312601b8583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S036030161100530X$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21640520$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22054442$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Creutzberg, Carien L., M.D., Ph.D</creatorcontrib><creatorcontrib>Nout, Remi A., M.D</creatorcontrib><creatorcontrib>Lybeert, Marnix L.M., M.D</creatorcontrib><creatorcontrib>Wárlám-Rodenhuis, Carla C., M.D</creatorcontrib><creatorcontrib>Jobsen, Jan J., M.D., Ph.D</creatorcontrib><creatorcontrib>Mens, Jan-Willem M., M.D</creatorcontrib><creatorcontrib>Lutgens, Ludy C.H.W., M.D., Ph.D</creatorcontrib><creatorcontrib>Pras, Elisabeth, M.D., Ph.D</creatorcontrib><creatorcontrib>van de Poll-Franse, Lonneke V., Ph.D</creatorcontrib><creatorcontrib>van Putten, Wim L.J., M.Sc</creatorcontrib><creatorcontrib>PORTEC Study Group</creatorcontrib><title>Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose To evaluate the very long-term results of the randomized Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-1 trial for patients with Stage I endometrial carcinoma (EC), focusing on the role of prognostic factors for treatment selection and the long-term risk of second cancers. Patients and Methods The PORTEC trial (1990–1997) included 714 patients with Stage IC Grade 1–2 or Stage IB Grade 2–3 EC. After surgery, patients were randomly allocated to external-beam pelvic radiotherapy (EBRT) or no additional treatment (NAT). Analysis was by intention to treat. Results 426 patients were alive at the date of analysis. The median follow-up time was 13.3 years. The 15-year actuarial locoregional recurrence (LRR) rates were 6% for EBRT vs. 15.5% for NAT ( p < 0.0001). The 15-year overall survival was 52% vs. 60% ( p = 0.14), and the failure-free survival was 50% vs. 54% ( p = 0.94). For patients with high-intermediate risk criteria, the 15-year overall survival was 41% vs. 48% ( p = 0.51), and the 15-year EC-related death was 14% vs. 13%. Most LRR in the NAT group were vaginal recurrences (11.0% of 15.5%). The 15-year rates of distant metastases were 9% vs. 7% ( p = 0.25). Second primary cancers had been diagnosed over 15 years in 19% of all patients, 22% vs. 16% for EBRT vs. NAT ( p = 0.10), with observed vs. expected ratios of 1.6 (EBRT) and 1.2 (NAT) compared with a matched population ( p = NS). Multivariate analysis confirmed the prognostic significance of Grade 3 for LRR (hazard ratio [HR] 3.4, p = 0.0003) and for EC death (HR 7.3, p < 0.0001), of age >60 (HR 3.9, p = 0.002 for LRR and 2.7, p = 0.01 for EC death) and myometrial invasion >50% (HR 1.9, p = 0.03 and HR 1.9, p = 0.02). Conclusions The 15-year outcomes of PORTEC-1 confirm the relevance of HIR criteria for treatment selection, and a trend for long-term risk of second cancers. EBRT should be avoided in patients with low- and intermediate-risk EC.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>BEAMS</subject><subject>Breast Neoplasms - epidemiology</subject><subject>CARCINOMAS</subject><subject>DEATH</subject><subject>Disease-Free Survival</subject><subject>Endometrial carcinoma</subject><subject>Endometrial Neoplasms - mortality</subject><subject>Endometrial Neoplasms - pathology</subject><subject>Endometrial Neoplasms - radiotherapy</subject><subject>Endometrial Neoplasms - surgery</subject><subject>FAILURES</subject><subject>Female</subject><subject>FOCUSING</subject><subject>HAZARDS</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Long-term outcome</subject><subject>METASTASES</subject><subject>Middle Aged</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasms, Second Primary - epidemiology</subject><subject>PATIENTS</subject><subject>Prognosis</subject><subject>Prognostic factors</subject><subject>Radiation therapy</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Randomized trial</subject><subject>Risk</subject><subject>SURGERY</subject><subject>Treatment Outcome</subject><subject>Vaginal Neoplasms - secondary</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk2L1EAQhoMo7rj6D0QCHvSSWP2RTuciyDC7Cgsj6wjrQZpOp8J2TNJjdyLM_no7ZvXgQU9NdT1VL1VvJclzAjkBIt50ue28q485BUJy4DkQ9iDZEFlWGSuKm4fJBpiAjEX4LHkSQgcQyZI_Ts4oERwKCpvk64VtJ8Qx-4Lap9e6sW66Ra-Pp3Q_T8YNGFLXpvEvJsfGDfYOm_Tj_vqw22YkPXir-7R1Pt0tSZx-xVvtjR3doJ8mj1rdB3x2_54nny92h-377Gp_-WH77iozhaymjBopJRdc0LagTS2qhjYVGMkZlICmJJIZNJLqtuIlirIVJdY1I1QAqWUh2Xnycu3rwmRVMHZCc2vcOKKZFKVQcM5ppF6t1NG77zOGSQ02GOx7PaKbg6riBqGoqiKSr_9JEiFLIRijPKJ8RY13IXhs1dHbQfuTIqAWo1SnVqPUYpQCrqJMLHtxrzDXAzZ_in47E4G3K4Bxbz8s-mUsHA021i9TNc7-T-HvBqa3ozW6_4YnDJ2b_Rg9UUQFqkB9Wo5luRVCAAoGN-wn6FS4Uw</recordid><startdate>20111115</startdate><enddate>20111115</enddate><creator>Creutzberg, Carien L., M.D., Ph.D</creator><creator>Nout, Remi A., M.D</creator><creator>Lybeert, Marnix L.M., M.D</creator><creator>Wárlám-Rodenhuis, Carla C., M.D</creator><creator>Jobsen, Jan J., M.D., Ph.D</creator><creator>Mens, Jan-Willem M., M.D</creator><creator>Lutgens, Ludy C.H.W., M.D., Ph.D</creator><creator>Pras, Elisabeth, M.D., Ph.D</creator><creator>van de Poll-Franse, Lonneke V., Ph.D</creator><creator>van Putten, Wim L.J., M.Sc</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20111115</creationdate><title>Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma</title><author>Creutzberg, Carien L., M.D., Ph.D ; Nout, Remi A., M.D ; Lybeert, Marnix L.M., M.D ; Wárlám-Rodenhuis, Carla C., M.D ; Jobsen, Jan J., M.D., Ph.D ; Mens, Jan-Willem M., M.D ; Lutgens, Ludy C.H.W., M.D., Ph.D ; Pras, Elisabeth, M.D., Ph.D ; van de Poll-Franse, Lonneke V., Ph.D ; van Putten, Wim L.J., M.Sc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c589t-2c88846462f52db69d2d90c843070ec7183cec82af947e67f67ebb312601b8583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>BEAMS</topic><topic>Breast Neoplasms - epidemiology</topic><topic>CARCINOMAS</topic><topic>DEATH</topic><topic>Disease-Free Survival</topic><topic>Endometrial carcinoma</topic><topic>Endometrial Neoplasms - mortality</topic><topic>Endometrial Neoplasms - pathology</topic><topic>Endometrial Neoplasms - radiotherapy</topic><topic>Endometrial Neoplasms - surgery</topic><topic>FAILURES</topic><topic>Female</topic><topic>FOCUSING</topic><topic>HAZARDS</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Long-term outcome</topic><topic>METASTASES</topic><topic>Middle Aged</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasms, Second Primary - epidemiology</topic><topic>PATIENTS</topic><topic>Prognosis</topic><topic>Prognostic factors</topic><topic>Radiation therapy</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Randomized trial</topic><topic>Risk</topic><topic>SURGERY</topic><topic>Treatment Outcome</topic><topic>Vaginal Neoplasms - secondary</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Creutzberg, Carien L., M.D., Ph.D</creatorcontrib><creatorcontrib>Nout, Remi A., M.D</creatorcontrib><creatorcontrib>Lybeert, Marnix L.M., M.D</creatorcontrib><creatorcontrib>Wárlám-Rodenhuis, Carla C., M.D</creatorcontrib><creatorcontrib>Jobsen, Jan J., M.D., Ph.D</creatorcontrib><creatorcontrib>Mens, Jan-Willem M., M.D</creatorcontrib><creatorcontrib>Lutgens, Ludy C.H.W., M.D., Ph.D</creatorcontrib><creatorcontrib>Pras, Elisabeth, M.D., Ph.D</creatorcontrib><creatorcontrib>van de Poll-Franse, Lonneke V., Ph.D</creatorcontrib><creatorcontrib>van Putten, Wim L.J., M.Sc</creatorcontrib><creatorcontrib>PORTEC Study Group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Creutzberg, Carien L., M.D., Ph.D</au><au>Nout, Remi A., M.D</au><au>Lybeert, Marnix L.M., M.D</au><au>Wárlám-Rodenhuis, Carla C., M.D</au><au>Jobsen, Jan J., M.D., Ph.D</au><au>Mens, Jan-Willem M., M.D</au><au>Lutgens, Ludy C.H.W., M.D., Ph.D</au><au>Pras, Elisabeth, M.D., Ph.D</au><au>van de Poll-Franse, Lonneke V., Ph.D</au><au>van Putten, Wim L.J., M.Sc</au><aucorp>PORTEC Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2011-11-15</date><risdate>2011</risdate><volume>81</volume><issue>4</issue><spage>e631</spage><epage>e638</epage><pages>e631-e638</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose To evaluate the very long-term results of the randomized Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC)-1 trial for patients with Stage I endometrial carcinoma (EC), focusing on the role of prognostic factors for treatment selection and the long-term risk of second cancers. Patients and Methods The PORTEC trial (1990–1997) included 714 patients with Stage IC Grade 1–2 or Stage IB Grade 2–3 EC. After surgery, patients were randomly allocated to external-beam pelvic radiotherapy (EBRT) or no additional treatment (NAT). Analysis was by intention to treat. Results 426 patients were alive at the date of analysis. The median follow-up time was 13.3 years. The 15-year actuarial locoregional recurrence (LRR) rates were 6% for EBRT vs. 15.5% for NAT ( p < 0.0001). The 15-year overall survival was 52% vs. 60% ( p = 0.14), and the failure-free survival was 50% vs. 54% ( p = 0.94). For patients with high-intermediate risk criteria, the 15-year overall survival was 41% vs. 48% ( p = 0.51), and the 15-year EC-related death was 14% vs. 13%. Most LRR in the NAT group were vaginal recurrences (11.0% of 15.5%). The 15-year rates of distant metastases were 9% vs. 7% ( p = 0.25). Second primary cancers had been diagnosed over 15 years in 19% of all patients, 22% vs. 16% for EBRT vs. NAT ( p = 0.10), with observed vs. expected ratios of 1.6 (EBRT) and 1.2 (NAT) compared with a matched population ( p = NS). Multivariate analysis confirmed the prognostic significance of Grade 3 for LRR (hazard ratio [HR] 3.4, p = 0.0003) and for EC death (HR 7.3, p < 0.0001), of age >60 (HR 3.9, p = 0.002 for LRR and 2.7, p = 0.01 for EC death) and myometrial invasion >50% (HR 1.9, p = 0.03 and HR 1.9, p = 0.02). Conclusions The 15-year outcomes of PORTEC-1 confirm the relevance of HIR criteria for treatment selection, and a trend for long-term risk of second cancers. EBRT should be avoided in patients with low- and intermediate-risk EC.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>21640520</pmid><doi>10.1016/j.ijrobp.2011.04.013</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of radiation oncology, biology, physics, 2011-11, Vol.81 (4), p.e631-e638 |
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| subjects | Adult Aged Aged, 80 and over Analysis of Variance BEAMS Breast Neoplasms - epidemiology CARCINOMAS DEATH Disease-Free Survival Endometrial carcinoma Endometrial Neoplasms - mortality Endometrial Neoplasms - pathology Endometrial Neoplasms - radiotherapy Endometrial Neoplasms - surgery FAILURES Female FOCUSING HAZARDS Hematology, Oncology and Palliative Medicine Humans Long-term outcome METASTASES Middle Aged MULTIVARIATE ANALYSIS Neoplasm Grading Neoplasm Recurrence, Local - mortality Neoplasms, Second Primary - epidemiology PATIENTS Prognosis Prognostic factors Radiation therapy Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Randomized trial Risk SURGERY Treatment Outcome Vaginal Neoplasms - secondary |
| title | Fifteen-Year Radiotherapy Outcomes of the Randomized PORTEC-1 Trial for Endometrial Carcinoma |
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