Radiation Therapy for Endometrial Cancer: An American Society for Radiation Oncology Clinical Practice Guideline

Harkenrider, Matthew M.; Abu‐Rustum, Nadeem R.; Albuquerque, Kevin; Bradfield, Lisa; Bradley, Kristin; Dolinar, Ellen; Doll, Corinne; Elshaikh, Mohamed A.; Frick, Melissa A.; Gehrig, Paola A.; Han, Kathy; Hathout, Lara; Jones, Ellen L.; Klopp, Ann H.; Mourtada, Firas; Suneja, Gita; Wright, Alexi A.; Yashar, Catheryn M.; Erickson, Beth

doi:10.1016/j.prro.2022.09.002

Cited by 40 publications

(40 citation statements)

References 112 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although this regimen has previously been shown to be well-tolerated by patients, with manageable hematologic toxicity in patients who were treated for highgrade endometrial cancers, [37][38][39] quality of evidence is low as the studies are mainly phase II and retrospective. 13 Although our study contributes to our understanding of racial disparities in endometrial cancer, it is not without limitations. Our study was retrospective in nature, which has inherent biases.…”

Section: Discussionmentioning

confidence: 91%

“…Because black patients were more likely to have more aggressive malignancies, this approach allows for sooner rather than later administration of RT by scheduling it in between two phases of chemotherapy. Although this regimen has previously been shown to be well-tolerated by patients, with manageable hematologic toxicity in patients who were treated for high-grade endometrial cancers,37–39 quality of evidence is low as the studies are mainly phase II and retrospective 13…”

Section: Discussionmentioning

confidence: 99%

“…Eligibility criteria included surgically staged FIGO stage IIIC1 and IIIC2 endometrial cancer who received both chemotherapy and radiation in an adjuvant setting with curative intent adherent to the recently published ASTRO guideline. 13 Patients with no recorded nodal sampling, carcinosarcoma histology, and those who did not receive both adjuvant chemotherapy and radiotherapy were excluded. All patients underwent total hysterectomy with salpingo-oophorectomy and lymph node assessment with or without pelvic washings.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma

Patrich

Wang

Elshaikh³

et al. 2023

American Journal of Clinical Oncology

Self Cite

View full text Add to dashboard Cite

Objective: To report the impact of race on clinical outcomes in patients with stage IIIC endometrial carcinoma. Materials and Methods: A retrospective multi-institutional study included 90 black and 568 non-black patients with stage IIIC endometrial carcinoma who received adjuvant chemotherapy and radiation treatments. Overall survival (OS) and recurrence-free survival (RFS) were calculated by the Kaplan-Meier method. Propensity score matching (PSM) was conducted. Statistical analyses were conducted using SPSS version 27. Results: The Median follow-up was 45.3 months. black patients were significantly older, had more nonendometrioid histology, grade 3 tumors, and were more likely to have >1 positive paraaortic lymph nodes compared with non-black patients (all P <0.0001). The 5-year estimated OS and RFS rates were 45% and 47% compared with 77% and 68% for black patients versus non-black patients, respectively (P <0.001). After PSM, the 2 groups were well-balanced for all prognostic covariates. The estimated hazard ratios of black versus non-black patients were 1.613 (P value=0.045) for OS and 1.487 (P value=0.116) for RFS. After PSM, black patients were more likely to receive the “Sandwich” approach and concurrent chemoradiotherapy compared with non-black (P=0.013) patients. Conclusions: Black patients have higher rates of nonendometrioid histology, grade 3 tumors, and number of involved paraaortic lymph nodes, worse OS, and RFS, and were more likely to receive the “Sandwich” approach compared with non-black patients. After PSM, black patients had worse OS with a nonsignificant trend in RFS. Access to care, equitable inclusion on randomized trials, and identification of genomic differences are warranted to help mitigate disparities.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma

Patrich

Wang

Elshaikh³

et al. 2023

American Journal of Clinical Oncology

Self Cite

View full text Add to dashboard Cite

show abstract

“…6 A number of international guidelines recently incorporated the molecular classification in risk assessment and adjuvant treatment recommendations, although mainly for high-risk EC. [7][8][9] The molecular class might also have clinically relevant implications in (high-) intermediate-risk EC, for which adjuvant radiotherapy is often recommended. [7][8][9][10] Whether the molecular classification has predictive value for benefit of radiotherapy has not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9] The molecular class might also have clinically relevant implications in (high-) intermediate-risk EC, for which adjuvant radiotherapy is often recommended. [7][8][9][10] Whether the molecular classification has predictive value for benefit of radiotherapy has not yet been investigated. There are several studies that show differences between the molecular classes in the ways cancer cells respond to damage induced by radiation.…”

Section: Introductionmentioning

confidence: 99%

Molecular Classification Predicts Response to Radiotherapy in the Randomized PORTEC-1 and PORTEC-2 Trials for Early-Stage Endometrioid Endometrial Cancer

Horeweg,

Nout,

Jürgenliemk-Schulz

et al. 2023

JCO

View full text Add to dashboard Cite

PURPOSE The molecular classification of endometrial cancer (EC) has proven to have prognostic value and is predictive of response to adjuvant chemotherapy. Here, we investigate its predictive value for response to external beam radiotherapy (EBRT) and vaginal brachytherapy (VBT) in early-stage endometrioid EC (EEC). METHODS Data of the randomized PORTEC-1 trial (n = 714) comparing pelvic EBRT with no adjuvant therapy in early-stage intermediate-risk EC and the PORTEC-2 trial (n = 427) comparing VBT with EBRT in early-stage high-intermediate-risk EC were used. Locoregional (including vaginal and pelvic) recurrence-free survival was compared between treatment groups across the four molecular classes using Kaplan-Meier's methodology and log-rank tests. RESULTS A total of 880 molecularly classified ECs, 484 from PORTEC-1 and 396 from PORTEC-2, were included. The majority were FIGO-2009 stage I EEC (97.2%). The median follow-up was 11.3 years. No locoregional recurrences were observed in EC with a pathogenic mutation of DNA polymerase-ε ( POLEmut EC). In mismatch repair–deficient (MMRd) EC, locoregional recurrence-free survival was similar after EBRT (94.2%), VBT (94.2%), and no adjuvant therapy (90.3%; P = .74). In EC with a p53 abnormality (p53abn EC), EBRT (96.9%) had a substantial benefit over VBT (64.3%) and no adjuvant therapy (72.2%; P = .048). In EC with no specific molecular profile (NSMP EC), both EBRT (98.3%) and VBT (96.2%) yielded better locoregional control than no adjuvant therapy (87.7%; P < .0001). CONCLUSION The molecular classification of EC predicts response to radiotherapy in stage I EEC and may guide adjuvant treatment decisions. Omitting radiotherapy seems to be safe in POLEmut EC. The benefit of radiotherapy seems to be limited in MMRd EC. EBRT yields a significantly better locoregional recurrence-free survival than VBT or no adjuvant therapy in p53abn EC. VBT is the treatment of choice for NSMP EC as it is as effective as EBRT and significantly better than no adjuvant therapy for locoregional tumor control.

show abstract

Screening for ferroptosis genes related to endometrial carcinoma and predicting of targeted drugs based on bioinformatics

Wang,

Lang,

Xue

et al. 2024

Arch Toxicol

View full text Add to dashboard Cite

Radiation Therapy for Endometrial Cancer: An American Society for Radiation Oncology Clinical Practice Guideline

Cited by 40 publications

References 112 publications

The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma

The Impact of Racial Disparities on Outcome in Patients With Stage IIIC Endometrial Carcinoma

Molecular Classification Predicts Response to Radiotherapy in the Randomized PORTEC-1 and PORTEC-2 Trials for Early-Stage Endometrioid Endometrial Cancer

Screening for ferroptosis genes related to endometrial carcinoma and predicting of targeted drugs based on bioinformatics

Contact Info

Product

Resources

About