Radiotherapy of Localized Endometrial Cancer, Experience of The Radiation Oncology Department of The Oncology-Hematology Center of The CHU Mohammed VI of Marrakesh: About 85 Cases

Abstract

Endometrial cancer is the most common gynecological cancer in developed countries. It mainly concerns postmenopausal women. The objective of our work is to report the experience of the radiotherapy oncology department of the oncology-hematology hospital (HOH) of the Mohammed IV University Hospital of Marrakesh in the management of endometrial cancer. We retrospectively analyzed 85 cases of endometrial cancer treated by radiotherapy (external radiotherapy and /or brachytherapy) in our institution between 2014 and 2019. The data collected from our patients concerned the epidemiological, clinical, therapeutic and evolutionary aspects of this cancer. The median age of the patients was 58 years [37, 82], 88% were postmenopausal. The average consultation time was 08 months. The master symptom was post-menopauseal bleeding in 85% of the patients. Pathological examination showed endometrioid adenocarcinoma in 83% of cases. After workup, 51% of patients were stage I (IA 17%, IB 35%), 25% stage II, 23% stage III (IIIA 3%, IIIB 9% and IIIC 10%) and 1% stage IVA according to the classification of the International Federation of Obstetric Gynecology (FIGO). After surgery, 77% of patients received external beam radiation therapy. The dose delivered was between 46 and 50 Gray (Gy) over a mean spread of 42 days associated with concomitant chemotherapy in 16% of cases. Intravaginal brachytherapy was delivered to 98% of patients. It represented the only adjuvant treatment in 27% of cases, after external radiotherapy in 73% of cases. Adjuvant chemotherapy was received in 36% of patients. After a mean follow-up of 3 years, 82% of patients were still followed in a situation of good control of their disease, 8% of cases of local recurrence and 10% of distant metastasis.