Radiation-related toxicities and outcomes in endometrial cancer: are obese women at a disadvantage?

Abstract

When comparing obese to non-obese women, obesity does not negatively impact the incidence of radiation toxicities in endometrial cancer. However, toxicities remain an important challenge as they are common and negatively influence the quality of life (QoL) of survivors. Future studies need to further explore the role of BMI and possible interventions to improve toxicities and QoL.

Acute chemoradiotherapy toxicity in cervical cancer patients

“…The development of ART may be explained also by the patient's constitution, regardless of the technique used. A study conducted by Smits et al shows that obesity and BMI over 30 kg/m 2 are not associated with higher grades of ART [40]. Similarly, another study show that obesity in young patients with endometrial cancer is not associated with the onset of genitourinary and gastrointestinal toxicities [41].…”

Acute radiation toxicity during and after concurrent chemoradiotherapy in patients with localy advanced cervical cancer

“…An increased incidence of acute gynecological radiation toxicity in young and obese patients with cancer of genital organs was noted, while urinary and gastrointestinal toxicity were not associated with obesity 58 . On the contrary, Smits et al claim that obesity and a body mass index over 30 kg/m 2 are not associated with the larger of radiation toxicity 59 .…”

Effect of patient thickness on acute gastrointestinal toxicities following radiotherapy for prostate cancer

“…Although there is published literature correlating patient size with the radiotherapy toxicities internationally [7][8][9][10][11][12][13], there is a lack of knowledge with regards to acute GI toxicities following PCa radiotherapy specifically.…”

“…Furthermore, the research findings of such articles were conflicting [7,9,12,13]. The majority of studies indicated that a larger patient size tended to reduce the incidence and severity of acute GI toxicities, and was attributed to a greater distance between the rectum and target due to adipose tissue [7,8,10,11].…”

“…Moreover, three other articles indicated that there was no significant association between patient size and toxicities. This lack of association was attributed to the use of highly accurate radiotherapy techniques, such as volume modulated arc therapy (VMAT) and image verification, which would improve treatment accuracy, thereby limiting the exposure of the adjacent organs at risk (OARs) [9,13,15].…”