福州市皮肤病医院青春痘长长就好了 ..76.pptVIP

Radiotherapy in high riskearly endometrial cancer;Endometrial cancer case;Endometrial cancer case(64 yo, Gr 2, LVSI+, 75% invasion);Endometrial cancer case(64 yo, Gr 2, LVSI+, 75% invasion);Endometrial cancer case(64 yo, Gr 2, LVSI+, 75% invasion);Endometrial cancer case(64 yo, Gr 2, LVSI+, 75% invasion, 50/50 LN-);Endometrial cancer case(64 yo, Gr 2, LVSI+, 75% invasion, 50/50 LN-);Radiotherapy in high-risk early endometrial cancer;Radiotherapy in high-risk early endometrial cancer - definitions;Proposed definition of ‘risk’ in EC;Endometrial cancer – general observations;Issues Prognostic factors and definitions of risk Extent of surgical staging Patterns of failure after surgery Toxicity of adjuvant therapy;Intrauterine pathologic prognostic factors;Does surgical extent alter risk in EC?;Without LNS, prognosis primarily based on grade and depth of myometrial invasion (DMI) Grade DMI predicts for LN+ Patients with LN+ now upstaged to IIIC Stage migration 92.7% 5-yr survival for pathological Stage I cancer with no adverse risk features other than grade and myoinvasion (Morrow, Gynecol Oncol 1991);Endometrial cancer case(64 yo, Gr 2, LVSI+, 75% invasion, 3/3 LN-);Aalders, Obstet Gynecol, 1980 540 St I pts, all received ICBT, 6000 rads Randomized to no vs 4000 rads pelvic RT No difference in overall survival or overall relapse Pelvic RT decreased pelvic failure, but altered pattern of failure ? benefit in patients with grade 3 and 50% DMI;Kucera, Gynecol Oncol 1990 Selective addition of pelvic RT to patients with high risk intrauterine features ‘equalized’ outcome to good prognostic group. Carey, Gynecol Oncol 1995 Selective use of pelvic RT in high risk patients achieved good overall outcome.;PORTEC (Creutzberg Lancet 2000, Sholten IJROBP 2005) 714 patients, ICG1, IBG2, ICG2, IBG3 ICG3 specifically NOT included Randomized to NAT vs 46 Gy pelvic RT No brachytherapy RT decreases LRF, but has no impact on survival RT not indicated in IBG2, 60 yo RT increases