Purpose: This systematic review focused on rare histological types of corpus uteri malignancy, including uterine carcinosarcoma (UCS), uterine clear cell carcinoma (UCCC), and uterine papillary serous carcinoma (UPSC), and it is proposed to assist with clinical decision-making. Adjuvant treatment decisions must be made based on available evidences. We mainly investigated the role of vaginal interventional radiotherapy (VIRt) in UCS, UCCC, and UPSC managements. Material and methods: A systematic research using PubMed and Cochrane library was conducted to identify full articles evaluating the efficacy of VIRt in early-stage UPSC, UCCC, and UCS. A search in ClinicalTrials.gov was performed in order to detect ongoing or recently completed trials as well as in PROSPERO for ongoing or recently completed systematic reviews. Survival outcomes and toxicity rates were obtained. Results: All studies were retrospective. For UCS, the number of evaluated patients was 432. The 2- to 5-year aver- age local control (LC) was 91% (range, 74.2-96%), disease-free survival (DFS) 88% (range, 82-94%), overall survival (OS) 79% (range, 53.8-84.3%), the average 5-year cancer-specific survival (CSS) was 70% (range, 70-94%), and G3-G4 toxicity was 0%. For UCCC, the number of investigated patients was 335 (UCCC – 124, mixed – 211), with an average 5-year LC of 100%, DFS of 83% (range, 82-90%), OS of 93% (range, 83-100%), and G3-G4 toxicity of 0%. For UPSC, the number of examined patients was 1,092 (UPSC – 866, mixed – 226). The average 5-year LC was 97% (range, 87.1-100%), DFS 84% (range, 74.7-95.6%), OS 93% (range, 71.9-100%), CSS 89% (range, 78.9-94%), and G3-G4 toxicity was 0%. Conclusions: These data suggest that in adequately selected early-stage UPSC and UCCC patients, VIRt alone may be suitable in women who underwent surgical staging and received adjuvant chemotherapy. In early-stage UCS, a multidisciplinary therapeutic approach has to be planned, considering high-rate of pelvic and distant relapses.

Adjuvant vaginal interventional radiotherapy in early-stage non-endometrioid carcinoma of corpus uteri: a systematic review / De Felice, F; Lancellotta, V; Vicenzi, L; Costantini, S; Antonacci, A; Cerboneschi, V; Di Cristino, D; Tagliaferri, L; Cerrotta, A; Vavassori, A; Gribaudo, S; Colombo, A; Lucà, F; Barbara, R; Mangoni, M; Marampon, F; Musio, D; Bellati, F; Ruscito, I; Torcia, F; Tombolini, V; Osti, Mf; De Sanctis, V.. - In: JOURNAL OF CONTEMPORARY BRACHYTHERAPY. - ISSN 1689-832X. - 13:2(2021), pp. 231-243. [10.5114/jcb.2021.105292]

Adjuvant vaginal interventional radiotherapy in early-stage non-endometrioid carcinoma of corpus uteri: a systematic review

De Felice F
Primo
;
Marampon F;Bellati F;Ruscito I;Torcia F;Tombolini V;Osti MF
Penultimo
;
De Sanctis V.
Ultimo
2021

Abstract

Purpose: This systematic review focused on rare histological types of corpus uteri malignancy, including uterine carcinosarcoma (UCS), uterine clear cell carcinoma (UCCC), and uterine papillary serous carcinoma (UPSC), and it is proposed to assist with clinical decision-making. Adjuvant treatment decisions must be made based on available evidences. We mainly investigated the role of vaginal interventional radiotherapy (VIRt) in UCS, UCCC, and UPSC managements. Material and methods: A systematic research using PubMed and Cochrane library was conducted to identify full articles evaluating the efficacy of VIRt in early-stage UPSC, UCCC, and UCS. A search in ClinicalTrials.gov was performed in order to detect ongoing or recently completed trials as well as in PROSPERO for ongoing or recently completed systematic reviews. Survival outcomes and toxicity rates were obtained. Results: All studies were retrospective. For UCS, the number of evaluated patients was 432. The 2- to 5-year aver- age local control (LC) was 91% (range, 74.2-96%), disease-free survival (DFS) 88% (range, 82-94%), overall survival (OS) 79% (range, 53.8-84.3%), the average 5-year cancer-specific survival (CSS) was 70% (range, 70-94%), and G3-G4 toxicity was 0%. For UCCC, the number of investigated patients was 335 (UCCC – 124, mixed – 211), with an average 5-year LC of 100%, DFS of 83% (range, 82-90%), OS of 93% (range, 83-100%), and G3-G4 toxicity of 0%. For UPSC, the number of examined patients was 1,092 (UPSC – 866, mixed – 226). The average 5-year LC was 97% (range, 87.1-100%), DFS 84% (range, 74.7-95.6%), OS 93% (range, 71.9-100%), CSS 89% (range, 78.9-94%), and G3-G4 toxicity was 0%. Conclusions: These data suggest that in adequately selected early-stage UPSC and UCCC patients, VIRt alone may be suitable in women who underwent surgical staging and received adjuvant chemotherapy. In early-stage UCS, a multidisciplinary therapeutic approach has to be planned, considering high-rate of pelvic and distant relapses.
endometrial cancer, rare tumor, adjuvant treatment, brachytherapy, radiotherapy
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Adjuvant vaginal interventional radiotherapy in early-stage non-endometrioid carcinoma of corpus uteri: a systematic review / De Felice, F; Lancellotta, V; Vicenzi, L; Costantini, S; Antonacci, A; Cerboneschi, V; Di Cristino, D; Tagliaferri, L; Cerrotta, A; Vavassori, A; Gribaudo, S; Colombo, A; Lucà, F; Barbara, R; Mangoni, M; Marampon, F; Musio, D; Bellati, F; Ruscito, I; Torcia, F; Tombolini, V; Osti, Mf; De Sanctis, V.. - In: JOURNAL OF CONTEMPORARY BRACHYTHERAPY. - ISSN 1689-832X. - 13:2(2021), pp. 231-243. [10.5114/jcb.2021.105292]
File allegati a questo prodotto
File Dimensione Formato  
De-Felice_Adjuvant_2021.pdf

solo gestori archivio

Tipologia: Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 271.63 kB
Formato Adobe PDF
271.63 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
De-Felice_Adjuvant_2021.pdf

accesso aperto

Note: https://www.termedia.pl/Adjuvant-vaginal-interventional-radiotherapy-r-nin-early-stage-non-endometrioid-carcinoma-r-nof-corpus-uteri-a-systematic-review,54,43839,0,1.html
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Creative commons
Dimensione 239.09 kB
Formato Adobe PDF
239.09 kB Adobe PDF Visualizza/Apri PDF

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1542327
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 2
social impact