Comparison of clinical outcomes and toxicity in endometrial cancer patients treated with adjuvant intensity-modulated radiation therapy or conventional radiotherapy

• Published in: Journal of the Formosan Medical Association 2014-12, Vol.113 (12), p.949-955
• Main Authors: Chen, Chien-Chih, Wang, Lily, Lu, Chien-Hsing, Lin, Jin-Ching, Jan, Jian-Sheng
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma - pathology; Carcinoma - radiotherapy; Carcinoma - surgery; conventional radiotherapy; Disease-Free Survival; endometrial cancer; Endometrial Neoplasms - pathology; Endometrial Neoplasms - radiotherapy; Endometrial Neoplasms - surgery; Female; Gastrointestinal Tract - radiation effects; Humans; intensity-modulated radiation therapy; Internal Medicine; Middle Aged; Radiation Injuries - etiology; Radiotherapy, Adjuvant - methods; Radiotherapy, Intensity-Modulated - adverse effects; Retrospective Studies; Survival Rate; toxicity; Treatment Outcome; Urogenital System - radiation effects
• ISSN: 0929-6646
• DOI: 10.1016/j.jfma.2013.09.013

Purpose To evaluate the treatment outcomes and toxicity in endometrial cancer patients treated with hysterectomy and adjuvant intensity-modulated radiation therapy (IMRT) or conventional radiotherapy (CRT). Methods There were 101 patients with stage IA-IIIC2 endometrial carcinoma treated with hysterectomy and adjuvant radiotherapy. In total, 36 patients received adjuvant CRT and 65 were treated with adjuvant IMRT. The endpoints were overall survival, local failure-free survival, and disease-free survival. Patients were assessed for acute toxicity weekly according to the Common Terminology Criteria for Adverse Events version 3.0. Late toxicity was evaluated according to the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Schema. Results The 5-year overall survival, local failure-free survival, and disease-free survival for the CRT group and the IMRT group were 82.9% versus 93.5% ( p  = 0.26), 93.7% versus 89.3% ( p  = 0.68), and 88.0% versus 82.8% ( p  = 0.83), respectively. Four (11.1%) patients had Grade 3 or greater acute gastrointestinal (GI) toxicity and three (8.3%) patients had Grade 3 or greater acute genitourinary (GU) toxicity in the CRT group, whereas four (6.2%) patients had Grade 3 or greater acute GI toxicity in the IMRT group and no patient had severe GU toxicity. There was one (2.8%) patient who had Grade 3 or greater late GI toxicity and one (2.8%) patient had Grade 3 or greater late GU toxicity in the CRT group, whereas no patient had severe GI or GU toxicity in the IMRT group. Conclusion Adjuvant IMRT for endometrial cancer patients had comparable clinical outcomes with CRT and had less acute and late toxicity.