{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:04:25Z","timestamp":1782950665501,"version":"3.54.5"},"reference-count":25,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T00:00:00Z","timestamp":1695772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Purpose: Analyse the outcomes of stages I\u2013III inoperable endometrial cancer (IEC) patients treated with external-beam-irradiation (EBRT) and 3D-image-guided-brachytherapy (IGBT). Material and Methods: Medical records of IEC patients receiving EBRT + IGBT in eight European and one Canadian centres (2004\u20132019) were examined, including: pelvic \u00b1 para-aortic EBRT and lymph node boost; anaesthetic procedure, applicators, BT-planning imaging, clinical target volume (CTV), brachytherapy schedule, and EQD2 to the CTV(\u03b1\/\u03b2=4.5Gy) and D2 cm3(\u03b1\/\u03b2=3Gy) for organs at risk. Complications are evaluated using CTCAEv4 scores. The 2- and 5-year survival probability according to stages was estimated (cancer-specific survival (CSS), disease-free survival (DFS), local relapse-free survival (LRFS), loco-regional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS)). Statistics: descriptive analysis and the Kaplan\u2013Meier method. Results: 103 patients (stages: I-44, II-14, III-44) were included. Median follow-up: 28 months (7\u2013170). All patients received pelvic \u00b1 para-aortic EBRT. Median D90-EQD2(\u03b1\/\u03b2=4.5) to the CTV:73.3 Gy (44.6\u2013132.7), 69.9 Gy (44.7\u201387.9 and 75.2 Gy (55.1\u201397) in stages I, II, and III, respectively. Thirty patients presented relapse (stages: 10-I, 3-II, 17-III): 24 uterine (stages: 7-I, 3-II, 14-III), 15 nodal (stages: 4-I, 1-II, 10-III), and 23 distant (stages: 6-I, 2-II, 15-III). Five year CSS was 71.2% (stages: 82%-I-II and 56%-III) and DFS, LRFS, LRRFS, and DMFS were 55.5%, 59%, 72%, and 67.2%, respectively. Late G3-G4 complications (crude): 1.3% small bowel, 2.5% rectum, and 5% bladder. Conclusion: In stages I\u2013III of the IEC, EBRT + IGBT offer good 2- and 5-year CSS of 88.7% and 71.2%, respectively, with the best outcomes in stages I\u2013II. Prospective studies are needed to determine how better outcomes can be achieved.<\/jats:p>","DOI":"10.3390\/cancers15194750","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T07:38:46Z","timestamp":1695800326000},"page":"4750","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Stages I\u2013III Inoperable Endometrial Carcinoma: A Retrospective Analysis by the Gynaecological Cancer GEC-ESTRO Working Group of Patients Treated with External Beam Irradiation and 3D-Image Guided Brachytherapy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7832-334X","authenticated-orcid":false,"given":"\u00c1ngeles","family":"Rovirosa","sequence":"first","affiliation":[{"name":"Fonaments Clinics Dpt., Faculty of Medicine, Universitat de Barcelona, 08036 Barcelona, Spain"},{"name":"Radiation Oncology Dpt., Hospital Clinic-Universitat de Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaowen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Cancer Center, Henan Provincial People\u2019s Hospital, Zhengzhou 450003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari","family":"Tanderup","sequence":"additional","affiliation":[{"name":"Danish Center for Particle Therapy, Institute of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Ascaso","sequence":"additional","affiliation":[{"name":"Fonaments Clinics Dpt., Faculty of Medicine, Universitat de Barcelona, 08036 Barcelona, Spain"},{"name":"Radiation Oncology Dpt., Hospital Clinic-Universitat de Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus","family":"Chargari","sequence":"additional","affiliation":[{"name":"Radiation Oncology Dpt., Institut Gustave Roussy, 94805 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elzbieta","family":"Van der Steen-Banasik","sequence":"additional","affiliation":[{"name":"Radiation Oncology Dpt., Radiotherapie Groep, 6815 AD Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Wojcieszek","sequence":"additional","affiliation":[{"name":"Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2608-1959","authenticated-orcid":false,"given":"Magdalena","family":"Stankiewicz","sequence":"additional","affiliation":[{"name":"Maria Sklodowska-Curie National Research Institute of Oncology, 44-102 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Najjari-Jamal","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e0 d\u2019Oncologia, l\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hoskin","sequence":"additional","affiliation":[{"name":"Mount Vernon Cancer Centre, Northwood, Middlesex HA6 2RN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Han","sequence":"additional","affiliation":[{"name":"Radiation Oncology Dpt., Princess Margaret Hospital, University Health Network, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0309-6282","authenticated-orcid":false,"given":"Barbara","family":"Segedin","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Institute of Oncology Ljubljana, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Potter","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Van Limbergen","sequence":"additional","affiliation":[{"name":"Radiation Oncology Dpt., University Hospital Gasthuisberg, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s40615-016-0292-2","article-title":"Endometrial Cancer Trends by Race and Histology in the USA: Projecting the Number of New Cases from 2015 to 2040","volume":"4","author":"Gaber","year":"2016","journal-title":"J. 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