Toxicity and Outcomes Associated with High-Dose Rate Brachytherapy for Medically Inoperable Endometrial Cancer

Yaney, Alexander; Healy, Erin; Wald, Patrick; Olsen, Meghan; Yıldız, Vedat; Martin, Douglas D.; Quick, Allison

doi:10.1016/j.brachy.2018.04.218

Cited by 2 publications

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“…In women who are not fit for surgery, regardless of age, primary radiotherapy is an option. Pelvic control rate is excellent for early stage endometrial cancer but 5-year OS varies widely from 30-95% [9][10][11][12][13][14][15][16][17]. In studies that have compared OS with cancer specific survival (CSS), the latter is often markedly higher [16,17], indicating that many patients succumb to underlying medical conditions.…”

Section: Introductionmentioning

confidence: 99%

Overall and cancer specific survival following radical or adjuvant (chemo)radiotherapy in a retrospective cohort of elderly patients with endometrial cancer

2022

European Journal of Gynaecological Oncology

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To report the overall survival and cancer specific survival outcomes of elderly women aged ≥70 years who received radical or adjuvant (chemo)radiotherapy for endometrial cancer, we conducted a retrospective review of 93 patients from the West of Scotland Cancer Network (WoSCAN) who received pelvic (+/− para-aortic) radiotherapy over a 5-year period (January 2011 to December 2015, inclusive). Association of treatment type and other variables with overall survival (OS) and cancer specific survival (CSS) were analysed using log rank tests and Cox proportional hazards models. Median age of the study population was 74 years (range 70–90 years); over 50% of patients were aged ≥75 years, and over 25% were ≥80 years. The majority of patients had endometrioid endometrial cancer (75.3%), and 24.7% had a high-risk histological subtype. Stage distribution was as follows: I/II (40.9%); III/IV (41.9%); recurrent disease (17.2%). Radiotherapy was predominantly delivered in the adjuvant setting (61.3%); intent was primary (22.6%) or salvage (16.1%) in the remaining patients. Chemotherapy was administered to almost 50% of the cohort, mainly in conjunction with adjuvant radiotherapy. After median follow up of 96 months, 5-year OS and CSS were 50.5%and CSS 59.3% for the entire series, 57.9% and 62.8% in the adjuvant group, 23.8% and 35.7% in the primary group, and 60.0% and 80.0% in the salvage group, respectively. Age ≥80 years and primary radiotherapy were statistically significant predictors of poorer survival, adjusting for pathology, stage and grade (hazard ratio (HR) 2.06, 95%Confidence Interval (CI) (1.11–3.80), p = 0.021; and HR 2.42 (CI 1.28–4.57), p = 0.006 respectively). In summary, poorer OS was associated with use of (chemo)radiotherapy as primary treatment of endometrial cancer and/or in women aged ≥80 years, suggesting that careful risk/benefit analysis is required in these two groups.

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Section: Introductionmentioning

confidence: 99%

Overall and cancer specific survival following radical or adjuvant (chemo)radiotherapy in a retrospective cohort of elderly patients with endometrial cancer

2022

European Journal of Gynaecological Oncology

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“…[165][166][167][168][169] Progestin therapy may be considered for postponing surgical management for temporary reasons of poor medical fitness or for surgery pre-habilitation, for example in the COVID-19 pandemic or during the acute recovery phase following myocardial infarction, stroke or fractured neck of femur. Intrauterine progestin may be preferred due to the low toxicity profile and small retrospective case series indicate moderate success rates [170].…”

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confidence: 99%

British Gynaecological Cancer Society (BGCS) uterine cancer guidelines: Recommendations for practice

Morrison

Balega

Buckley

et al. 2022

European Journal of Obstetrics & Gynecology and Reproductiv

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Toxicity and Outcomes Associated with High-Dose Rate Brachytherapy for Medically Inoperable Endometrial Cancer

Cited by 2 publications

References 0 publications

Overall and cancer specific survival following radical or adjuvant (chemo)radiotherapy in a retrospective cohort of elderly patients with endometrial cancer

Overall and cancer specific survival following radical or adjuvant (chemo)radiotherapy in a retrospective cohort of elderly patients with endometrial cancer

British Gynaecological Cancer Society (BGCS) uterine cancer guidelines: Recommendations for practice

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