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. 2024 Feb 1;25(2):485-494.
doi: 10.31557/APJCP.2024.25.2.485.

Retrospective Analysis of All Types of Adjuvant Radiotherapy in Endometrial Cancer: Single-Center Experiences in a Middle-Income Country

Nadee Chitapanarux  1 , Ekkasit Tharavichitkul  2 , Kittikun Kittidachanan  2 , Pooriwat Muangwong  2 , Somvilai Chakrabandhu  2 , Pitchayaponne Klunklin  2 , Wimrak Onchan  2 , Bongkot Jia-Mahasap  2 , Piyapasara Torapichattrakul  2 , Imjai Chitapanarux  2
Affiliations

Retrospective Analysis of All Types of Adjuvant Radiotherapy in Endometrial Cancer: Single-Center Experiences in a Middle-Income Country

Nadee Chitapanarux et al. Asian Pac J Cancer Prev. .

Abstract

Objective: We retrospectively analyzed the efficacy, focusing on overall survival (OS) and the patterns of failure, along with the toxicities of adjuvant radiotherapy (RT) in endometrial cancer patients.

Methods: Two-hundred and nineteen patients with endometrial cancer patients who received adjuvant radiotherapy ± adjuvant chemotherapy (ACT) from January 2014 to December 2018 were investigated for overall survival (OS), local recurrence-free survival rate (LRFS), regional recurrence-free survival rate (RRFS), and distant metastasis-free survival rate (DMFS).

Result: Two-hundred and fourteen patients were evaluated. The numbers of VBT alone, EBRT plus VBT, and adjuvant chemotherapy (ACT) plus EBRT plus VBT were 65 (30.4%), 80 (37.4%), and 69 (32.2%) patients, respectively. Stage I (107 patients) was the most common followed by stage III (87 patients). With a median follow-up time of 67 months (IQR 56-78), the 5-year overall survival rates for VBT alone, EBRT plus VBT, and EBRT plus VBT plus ACT were 84.4%, 65%, and 57.4%, respectively. The most common severe (grade 3-4) acute toxicity was neutropenia (4.6%), followed by diarrhea (3.7%). Grade 3-4 late proctitis was found in only 1.9%. On multivariate analysis, advanced age (HR 6.15, p: 0.015), lymph node involvement (HR 6.66, p: 0.039), cervical involvement (HR 10.60, p: 0.029), and substantial LVSI (HR 21.46, p: 0.005) were associated with a higher risk of death.

Conclusion: Advanced age (>65), substantial LVSI, lymph node involvement, and cervical stromal involvement were associated with poor overall survival. These findings here will help identifying high-risk patients and would make it possible to avoid unnecessary adjuvant treatment among patients with a good prognosis.

Keywords: Adjuvant radiotherapy; Endometrial cancer; middle-income country; toxicities; treatment outcomes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consort Diagram of This Study
Figure 2
Figure 2
Selected Kaplan-Meier Curves Demonstrated Overall Survival of the whole Group (a), age >65 years (b), substantial lympho-vascular invasion (c), cervical involvement
Figure 2
Figure 2
Selected Kaplan-Meier Curves Demonstrated Overall Survival of the whole Group (d), and presented Lymph nodes (e) in the whole group (N = 214)
See this image and copyright information in PMC

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