Definitive Radiation Therapy for Medically Inoperable Endometrial Carcinoma

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.