Ken Tatebe1, Yasmin Hasan1, Christina H Son2. 1. University of Chicago Medicine, Department of Radiation and Cellular Oncology, Chicago, IL, USA. 2. University of Chicago Medicine, Department of Radiation and Cellular Oncology, Chicago, IL, USA. Electronic address: cson@radonc.uchicago.edu.
Abstract
OBJECTIVE: To report on patterns of care as well as evaluate the two treatment regimens using a large retrospective hospital-based registry to identify possible subgroups of patients who may experience benefit with VBT + CT vs. EBRT. METHODS:Patients from the National Cancer Database (NCDB) were identified who met the inclusion criteria for GOG 249 and were treated with eitherVBT + CT or WPRT. Demographic, clinicopathologic, and treatment factors were collected. Association of treatment type and other variables with overall survival was analyzed using Cox proportional hazards model. Subset analyses were performed based on a variety of risk factors, including high risk pathologies, surgical nodal sampling, and grade. RESULTS: A total of 4,602 patients were included in the analysis, with 41% receivingVBT + CT and 59% receiving WPRT. For the entire cohort, VBT + CT was associated with improved survival, with 3-year overall survival 89.6% vs. 87.8% (hazard ratio 1.24, 95%CI 1.01-1.52, p = 0.04). On subset analysis, patients with serous histology experienced benefit with VBT + CT, while high-grade endometrial patients without lymph node dissection experienced improved survival associated with EBRT. After exclusion of serous histology, there was no survival difference associated with treatment type. CONCLUSIONS:VBT + CT was associated with superior survival outcomes in patients with early-stage serous carcinoma. For non-serous histology, treatment modality was not associated with a difference in survival, although patients with high-grade disease and no nodal dissection experienced benefit from EBRT.
RCT Entities:
OBJECTIVE: To report on patterns of care as well as evaluate the two treatment regimens using a large retrospective hospital-based registry to identify possible subgroups of patients who may experience benefit with VBT + CT vs. EBRT. METHODS:Patients from the National Cancer Database (NCDB) were identified who met the inclusion criteria for GOG 249 and were treated with either VBT + CT or WPRT. Demographic, clinicopathologic, and treatment factors were collected. Association of treatment type and other variables with overall survival was analyzed using Cox proportional hazards model. Subset analyses were performed based on a variety of risk factors, including high risk pathologies, surgical nodal sampling, and grade. RESULTS: A total of 4,602 patients were included in the analysis, with 41% receiving VBT + CT and 59% receiving WPRT. For the entire cohort, VBT + CT was associated with improved survival, with 3-year overall survival 89.6% vs. 87.8% (hazard ratio 1.24, 95%CI 1.01-1.52, p = 0.04). On subset analysis, patients with serous histology experienced benefit with VBT + CT, while high-grade endometrialpatients without lymph node dissection experienced improved survival associated with EBRT. After exclusion of serous histology, there was no survival difference associated with treatment type. CONCLUSIONS:VBT + CT was associated with superior survival outcomes in patients with early-stage serous carcinoma. For non-serous histology, treatment modality was not associated with a difference in survival, although patients with high-grade disease and no nodal dissection experienced benefit from EBRT.
Authors: Giorgio Bogani; Isabelle Ray-Coquard; Nicole Concin; Natalie Y L Ngoi; Philippe Morice; Takayuki Enomoto; Kazuhiro Takehara; Hannelore Denys; Remi A Nout; Domenica Lorusso; Michelle M Vaughan; Marta Bini; Masashi Takano; Diane Provencher; Alice Indini; Satoru Sagae; Pauline Wimberger; Robert Póka; Yakir Segev; Se Ik Kim; Francisco J Candido Dos Reis; Salvatore Lopez; Andrea Mariani; Mario M Leitao; Francesco Raspagliesi; Pieluigi Benedetti Panici; Violante Di Donato; Ludovico Muzii; Nicoletta Colombo; Giovanni Scambia; Sandro Pignata; Bradley J Monk Journal: Gynecol Oncol Date: 2021-04-30 Impact factor: 5.304