{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:09:12Z","timestamp":1791871752447,"version":"4.3.4"},"reference-count":20,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"21","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2019,7,20]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>The primary objective was to determine if vaginal cuff brachytherapy and chemotherapy (VCB\/C) increases recurrence-free survival (RFS) compared with pelvic radiation therapy (RT) in high-intermediate and high-risk early-stage endometrial carcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS AND METHODS<\/jats:title>\n                    <jats:p>\n                      A randomized phase III trial was performed in eligible patients with endometrial cancer. Eligible patients had International Federation of Gynecology and Obstetrics (2009) stage I endometrioid histology with Gynecologic Oncology Group protocol 33\u2013based high-intermediate\u2013risk criteria, stage II disease, or stage I to II serous or clear cell tumors. Treatment was randomly assigned between RT (45 to 50.4 Gy over 5 weeks) or VCB followed by intravenous paclitaxel 175 mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (3 hours) plus carboplatin (area under the curve, 6) every 21 days for three cycles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The median age of the 601 patients was 63 years, and 74% had stage I disease. Histologies included endometrioid (71%), serous (15%), and clear cell (5%). With a median follow-up of 53 months, the 60-month RFS was 0.76 (95% CI, 0.70 to 0.81) for RT and 0.76 (95% CI, 0.70 to 0.81) for VCB\/C (hazard ratio, 0.92; 90% confidence limit, 0.69 to 1.23). The 60-month overall survival was 0.87 (95% CI, 0.83 to 0.91) for RT and 0.85 (95% CI, 0.81 to 0.90) for VCB\/C (hazard ratio, 1.04; 90% confidence limit, 0.71 to 1.52). Vaginal and distant recurrence rates were similar between arms. Pelvic or para-aortic nodal recurrences were more common with VCB\/C (9% v 4%). There was no heterogeneity of treatment effect with respect to RFS or overall survival among clinical or pathologic variables evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Superiority of VCB\/C compared with pelvic RT was not demonstrated. Acute toxicity was greater with VCB\/C; late toxicity was similar. Pelvic RT alone remains an effective, well-tolerated, and appropriate adjuvant treatment in high-risk early-stage endometrial carcinomas of all histologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.18.01575","type":"journal-article","created":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T16:00:18Z","timestamp":1555516818000},"page":"1810-1818","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":310,"title":["Phase III Trial: Adjuvant Pelvic Radiation Therapy Versus Vaginal Brachytherapy Plus Paclitaxel\/Carboplatin in High-Intermediate and High-Risk Early-Stage Endometrial Cancer"],"prefix":"10.1200","volume":"37","author":[{"given":"Marcus E.","family":"Randall","sequence":"first","affiliation":[{"name":"University of Kentucky, Lexington, KY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Filiaci","sequence":"additional","affiliation":[{"name":"NRG Oncology Statistical and Data Center, Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Scott","family":"McMeekin","sequence":"additional","affiliation":[{"name":"University of Oklahoma School of Medicine, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"von Gruenigen","sequence":"additional","affiliation":[{"name":"Summa Health System, Akron, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Huang","sequence":"additional","affiliation":[{"name":"NRG Oncology Statistical and Data Center, Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catheryn M.","family":"Yashar","sequence":"additional","affiliation":[{"name":"University of California San Diego, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Mannel","sequence":"additional","affiliation":[{"name":"University of Oklahoma School of Medicine, Oklahoma City, OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Weon","family":"Kim","sequence":"additional","affiliation":[{"name":"Seoul National University, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Salani","sequence":"additional","affiliation":[{"name":"Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"DiSilvestro","sequence":"additional","affiliation":[{"name":"Women and Infants Hospital, Providence, RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Burke","sequence":"additional","affiliation":[{"name":"Mercer University, Savannah, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Rutherford","sequence":"additional","affiliation":[{"name":"Yale University, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick M.","family":"Spirtos","sequence":"additional","affiliation":[{"name":"Women\u2019s Cancer Center of Nevada, Las Vegas, NV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Terada","sequence":"additional","affiliation":[{"name":"University of Hawaii, Honolulu, HI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Fox Chase Cancer Center, Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy R.","family":"Brewster","sequence":"additional","affiliation":[{"name":"University of North Carolina Chapel Hill, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Small","sequence":"additional","affiliation":[{"name":"Loyola University, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Aghajanian","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Miller","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21442"},{"key":"B2","first-page":"419","volume":"56","author":"Aalders J","year":"1980","journal-title":"Obstet Gynecol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02139-5"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2003.11.048"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs374"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.4590"},{"key":"B7","doi-asserted-by":"crossref","unstructured":"Creutzberg CL, Nout RA, Lybeert ML, et al: Fifteen-year radiotherapy outcomes of the randomized PORTEC-1 trial for endometrial carcinoma. 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