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Definitive Radiation Therapy for Medically Inoperable Endometrial Carcinoma.

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Upfront radiation therapy is effective for medically inoperable endometrial carcinoma patients, showing excellent cancer-free survival (CFS), cancer-specific survival (CSS), and overall survival (OS). Outcomes were better for low-risk endometrial carcinoma (LREC) than high-risk (HREC), with limited toxic effects.

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Area of Science:

  • Gynecologic Oncology
  • Radiation Oncology
  • Medical Oncology

Background:

  • Upfront radiation therapy is a standard treatment for medically inoperable endometrial carcinoma.
  • This approach includes brachytherapy with or without external beam radiation therapy.
  • Evaluating survival outcomes and toxicities is crucial for this patient population.

Purpose of the Study:

  • To evaluate the cancer-free survival (CFS), cancer-specific survival (CSS), and overall survival (OS) in patients with endometrial carcinoma treated with definitive-intent radiation therapy.
  • To compare outcomes between low-risk endometrial carcinoma (LREC) and high-risk endometrial carcinoma (HREC) cohorts.
  • To report on the incidence of severe toxic effects (grade ≥3) in patients undergoing radiation therapy.

Main Methods:

  • Retrospective analysis of 55 medically inoperable endometrial carcinoma patients treated between May 2010 and October 2021.
  • Patients were stratified into LREC (uterine-confined grade 1-2 endometrioid adenocarcinoma) and HREC (advanced stage or aggressive histology).
  • Treatment involved high-dose-rate brachytherapy alone or combined with external beam radiation therapy, with or without chemotherapy.

Main Results:

  • The 2-year CFS was 82% for LREC and 80% for HREC (P=.0654).
  • The 2-year CSS was 100% for both LREC and HREC patients.
  • The 2-year OS was 92% for LREC and 80% for HREC (P=.0064), with no acute grade ≥3 toxic effects and 3 late grade ≥3 toxic effects.

Conclusions:

  • Definitive-intent radiation therapy offers excellent CFS, CSS, and OS for medically inoperable endometrial carcinoma patients.
  • Patients with LREC demonstrated superior CSS and OS compared to HREC patients.
  • The treatment regimen was associated with a low incidence of severe toxic effects.