Postoperative Pelvic Lymph Node Recurrence of Uterine Endometrioid Carcinoma with a Long-Term Complete Response to Carbon-ion Radiation Therapy: A Case Report

Abstract

Synopsis: Recurrent uterine corpus cancer is typically challenging to eradicate definitively. Although surgery and radiotherapy are viable options against isolated recurrent lesions, more definitive therapies are being sought. We report a case of carbon-ion beam therapy (CIRT) administered for isolated pelvic recurrence following surgery and adjuvant chemotherapy for endometrial cancer. The patient was a 40s female who underwent radical surgery and postoperative chemotherapy for stage IIIC2 uterine endometrioid cancer (FIGO 2008). Six months after completion of treatment, she developed pelvic lymph node recurrence and left hydronephrosis. After receiving 52.8 Gy/12 fractions of CIRT, hydronephrosis improved alongside tumor shrinkage, and she has maintained clinical disease-free status for 12 years without developing any serious late complications. CIRT may provide long-term local control of isolated recurrent uterine corpus cancer and could represent a salvage treatment option. Furthermore, no ureteral stricture has developed during the long-term follow-up, suggesting that CIRT is feasible even for lesions adjacent to the ureter.