QOL With Shorter RT Equal to Standard in Endometrial Cancer

TOPLINE:

Short-course vaginal cuff brachytherapy (VCB) demonstrated noninferiority in quality of life for patients with early endometrial cancer vs standard regimens, in a prospective randomized trial. The study also found acceptable short-term toxicity and cancer control with the shorter duration of treatment.

METHODOLOGY:

• A prospective, randomized, multicenter trial compared short-course adjuvant VCB (11 Gy × 2 fractions at surface) with standard regimens (7 Gy × 3 fractions at 0.5 cm depth, 6 Gy × 5 fractions at vaginal surface, or 5-5.5 Gy × 4 fractions at 0.5 cm depth).
• Participants included 108 patients with pathologically confirmed endometrioid adenocarcinoma, serous sarcoma, clear cell sarcoma, or carcinosarcoma who underwent hysterectomy.
• Inclusion criteria specified stage I and II cancers, with lymphovascular invasion required for stage IAG1.
• The primary outcome measure focused on Global Health Status using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Module, with a prespecified noninferiority margin of 15 points.

TAKEAWAY:

• Each study arm enrolled 54 patients, with the experimental arm demonstrating noninferiority to standard of care at 1 month (P = .000005) and 12 months (P = .0005).
• Patient-reported vaginal/sexual, urologic, and gastrointestinal symptoms showed no significant differences in mean symptom scores between arms from baseline to 1 and 12 months.
• Short-term adverse events related to study treatment occurred in 37% of experimental arm patients vs 57% of control arm patients (P = .053).
• At 28-month median follow-up, both arms achieved 96% vaginal control rate, with the experimental arm showing 100% isolated vaginal control.

IN PRACTICE:

“This study offers a new, equally effective brachytherapy fractionation regimen for endometrial carcinoma [as standard regimens] that cuts hospital costs and time without increasing toxicity, providing [an] evidence-based alternative to standard care,” the authors of the new paper wrote.

SOURCE:

This study was led by Gita Suneja, MD, Huntsman Cancer Institute, University of Utah in Salt Lake City. It was published online on December 4 in JCO Oncology Advances.

LIMITATIONS:

According to the authors, the follow-up duration only allowed examination of short-term quality of life, with short-term treatment toxicity and disease outcomes as exploratory outcomes. While published data suggest global health, gastrointestinal toxicity, and sexual activity scores typically stabilize after 12-24 months post-treatment, research suggests longer monitoring of urinary urgency scores than was done in the new study may be needed for comprehensive urinary function assessment. Additionally, the timing of quality-of-life questionnaires may have coincided with chemotherapy administration for some participants, potentially affecting toxicity scoring.

DISCLOSURES:

The study received funding from Elekta and the Huntsman Cancer Institute.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.