Literature DB >> 28620815

Radiation-related toxicities and outcomes in endometrial cancer: are obese women at a disadvantage?

A Smits1, J McGrane2, A Lopes1, E Kent1, R Bekkers3, L Massuger3, N Simpson4, K Galaal1.   

Abstract

OBJECTIVE: To assess the impact of body mass index (BMI) on radiotherapy toxicities in endometrial cancer patients.
METHODS: This was a retrospective cohort study of women diagnosed with endometrial cancer between January 2006 and December 2014 at the Royal Cornwall Hospital Trust. Women who received radiotherapy as part of their treatment, including external beam radiotherapy (EBRT) and/or vaginal brachytherapy were included. Radiation-related toxicities were graded according to the Radiation Therapy Oncology Group (RTOG) guidelines. Toxicity outcomes were compared across BMI groups-non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2)-according to radiotherapy treatment received (EBRT, brachytherapy or a combination).
RESULTS: Of a total of 159 women who received radiotherapy, 110 were eligible for inclusion in the study. Sixty-three women had a BMI <30 kg/m2 and 47 women were obese. Obese women had poorer Eastern Cooperative Oncology Group performance status (P = 0.021) and more comorbidities (P < 0.001) compared to the non-obese group. Total (any) toxicity rates were 60.3, 72.7 and 52.0% for EBRT and brachytherapy (N = 63), single-mode EBRT (N = 22) and brachytherapy (N = 25), respectively. BMI was not associated with the incidence of acute and late radiation toxicities in the different radiotherapy groups, and there were no differences in individual complications between the BMI groups.
CONCLUSION: When comparing obese to non-obese women, obesity does not negatively impact the incidence of radiation toxicities in endometrial cancer. However, toxicities remain an important challenge as they are common and negatively influence the quality of life (QoL) of survivors. Future studies need to further explore the role of BMI and possible interventions to improve toxicities and QoL.

Entities:  

Keywords:  Endometrial cancer; Obesity; Radiation; Toxicity

Mesh:

Year:  2017        PMID: 28620815     DOI: 10.1007/s10147-017-1147-5

Source DB:  PubMed          Journal:  Int J Clin Oncol        ISSN: 1341-9625            Impact factor:   3.402


  27 in total

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2.  Role of image guided radiation therapy in obese patients with gynecologic malignancies.

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3.  Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial.

Authors:  R A Nout; V T H B M Smit; H Putter; I M Jürgenliemk-Schulz; J J Jobsen; L C H W Lutgens; E M van der Steen-Banasik; J W M Mens; A Slot; M C Stenfert Kroese; B N F M van Bunningen; A C Ansink; W L J van Putten; C L Creutzberg
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4.  Intensity-modulated whole pelvic radiotherapy in women with gynecologic malignancies.

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5.  Treatment effects, disease recurrence, and survival in obese women with early endometrial carcinoma : a Gynecologic Oncology Group study.

Authors:  Vivian E von Gruenigen; Chunqiao Tian; Heidi Frasure; Steven Waggoner; Henry Keys; Richard R Barakat
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6.  Utilising pseudo-CT data for dose calculation and plan optimization in adaptive radiotherapy.

Authors:  Brendan Whelan; Shivani Kumar; Jason Dowling; Jarrad Begg; Jonathan Lambert; Karen Lim; Shalini K Vinod; Peter B Greer; Lois Holloway
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7.  The impact of BMI on quality of life in obese endometrial cancer survivors: does size matter?

Authors:  Anke Smits; Alberto Lopes; Nagindra Das; Ruud Bekkers; Khadra Galaal
Journal:  Gynecol Oncol       Date:  2013-11-18       Impact factor: 5.482

8.  External pelvic and vaginal irradiation versus vaginal irradiation alone as postoperative therapy in medium-risk endometrial carcinoma: a prospective, randomized study--quality-of-life analysis.

Authors:  Bengt Göran Sorbe; György Horvath; Håkan Andersson; Karin Boman; Caroline Lundgren; Birgitta Pettersson
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9.  Global burden of cancer attributable to high body-mass index in 2012: a population-based study.

Authors:  Melina Arnold; Nirmala Pandeya; Graham Byrnes; Prof Andrew G Renehan; Gretchen A Stevens; Prof Majid Ezzati; Jacques Ferlay; J Jaime Miranda; Isabelle Romieu; Rajesh Dikshit; David Forman; Isabelle Soerjomataram
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Review 10.  Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis.

Authors:  P Blake; Ann Marie Swart; J Orton; H Kitchener; T Whelan; H Lukka; E Eisenhauer; M Bacon; D Tu; M K B Parmar; C Amos; C Murray; W Qian
Journal:  Lancet       Date:  2008-12-16       Impact factor: 79.321

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1.  Toxicity and Efficacy After Adjuvant Vaginal Brachytherapy Using 30 Gy in 6 Fractions for Stages I and II Endometrial Cancer.

Authors:  Jessica D Arden; Jonathan Dokter; Muayad F Almahariq; Kimberly Marvin; Sirisha R Nandalur; Zaid Al-Wahab; Jill Gadzinski; Barry Rosen; Maha Saada Jawad
Journal:  Adv Radiat Oncol       Date:  2021-08-12

2.  Effect of patient thickness on acute gastrointestinal toxicities following radiotherapy for prostate cancer.

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