Postoperative radiation therapy for surgically staged XXXX : impact of time factors (overall treatment time and surgery-to-radiation interval) on outcome.

@entity1204 @entity1 @entity5 @entity66
PURPOSE: To evaluate the impact of prolonged overall radiation treatment (RT) time and surgery-to-radiation interval on local control (LC) and @entity66 ( @entity66 ) of surgically staged @entity1204 @entity1 in relation to known prognostic factors. METHODS AND MATERIALS: Between 1971 and 1993, 195 @entity1204 @entity1 received postoperative RT at the Fox Chase @entity5 Center. All @entity1 underwent total abdominal hysterectomy (TAH), with 38% also having lymph node sampling. All @entity1 received whole pelvic external beam RT to a median dose of 45 Gy (range 40 to 60 Gy). Sixty-nine percent received a vaginal cuff boost with either low dose rate or high dose rate brachytherapy. @entity5 and treatment factors were analyzed for impact on LC and @entity66 . Median follow-up was 47 months (range: 6 to 187 months). RESULTS: The overall actuarial 5-year LC rate was 85%. In multivariate analysis, @entity5 grade, pathologic stage, external radiation dose, and surgical lymph node evaluation were independent prognostic variables for improved LC. Surgery-to-radiation interval of greater than 6 weeks was a marginally significant factor for decreased LC (p = 0.06). Overall RT time and external beam treatment time did not appear to impact LC rates. The overall actuarial 5-year @entity66 rate was 86%. In multivariate analysis, depth of myometrial invasion, @entity5 grade, and pathologic stage were independent prognostic variables for @entity66 . In addition, a surgery-to-radiation interval of greater than 6 weeks was significantly associated with decreased @entity66 (p < 0.005). CONCLUSIONS: Surgery-to-radiation interval of greater than 6 weeks is a significant independent prognostic variable for decreased @entity66 and a marginally significant variable for decreased LC in @entity1 irradiated postoperatively for @entity1204 . Other time factors (overall RT time and external beam treatment time) did not appear to impact outcome. Based on this analysis, postoperative radiation therapy for @entity1204 should be initiated within 6 weeks following surgery.
