Bastiaan G Wortman1, Cathalijne C B Post2, Melanie E Powell3, Pearly Khaw4, Anthony Fyles5, Romerai D'Amico6, Christine Haie-Meder7, Ina M Jürgenliemk-Schulz8, Mary McCormack9, Viet Do10, Dionyssios Katsaros11, Paul Bessette12, Marie Hélène Baron13, Remi A Nout2, Karen Whitmarsh14, Linda Mileshkin15, Ludy C H W Lutgens16, Henry C Kitchener17, Susan Brooks18, Hans W Nijman19, Eleftheria Astreinidou2, Hein Putter20, Carien L Creutzberg2, Stephanie M de Boer2. 1. Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: b.g.wortman@lumc.nl. 2. Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Clinical Oncology, Barts Health NHS Trust, London, United Kingdom. 4. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. 5. Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada. 6. Department of Radiotherapy, Azienda Socio Sanitaria Territoriale, Lecco, Italy. 7. Department of Radiotherapy, Institute Gustave Roussy, Villejuif, France. 8. Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands. 9. Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom. 10. Radiation Oncology, Liverpool & Macarthur Cancer Therapy Center, NSW, Australia. 11. Department of Surgical Sciences, Gynecologic Oncology, Città della Salute and Sant'Anna Hospital, University of Turin, Turin, Italy. 12. Gynecologic Oncology, University of Sherbrooke, Sherbrooke, Quebec, Canada. 13. Department of Radiotherapy, Centre Hospitalier Régional Universitaire de Besançon, Besançon, France. 14. The Clatterbridge Cancer Center, Bebington, United Kingdom. 15. Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. 16. Department of Radiation Oncology, MAASTRO, Maastricht, The Netherlands. 17. Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom. 18. Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand. 19. Department of Gynecologic Oncology, University Medical Center Groningen, Groningen, The Netherlands. 20. Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
PURPOSE: Radiation therapy techniques have developed from 3-dimensional conformal radiation therapy (3DCRT) to intensity modulated radiation therapy (IMRT), with better sparing of the surrounding normal tissues. The current analysis aimed to investigate whether IMRT, compared to 3DCRT, resulted in fewer adverse events (AEs) and patient-reported symptoms in the randomized PORTEC-3 trial for high-risk endometrial cancer. METHODS AND MATERIALS: Data on AEs and patient-reported quality of life (QoL) of the PORTEC-3 trial were available for analysis. Physician-reported AEs were graded using Common Terminology Criteria for Adverse Events v3.0. QoL was assessed by the European Organisation for Research and Treatment of Cancer QLQC30, CX24, and OV28 questionnaires. Data were compared between 3DCRT and IMRT. A P value of ≤ .01 was considered statistically significant due to the risk of multiple testing. For QoL, combined scores 1 to 2 ("not at all" and "a little") versus 3 to 4 ("quite a bit" and "very much") were compared between the techniques. RESULTS: Of 658 evaluable patients, 559 received 3DCRT and 99 IMRT. Median follow-up was 74.6 months. During treatment no significant differences were observed, with a trend for more grade ≥3 AEs, mostly hematologic and gastrointestinal, after 3DCRT (37.7% vs 26.3%, P = .03). During follow-up, 15.4% (vs 4%) had grade ≥2 diarrhea, and 26.1% (vs 13.1%) had grade ≥2 hematologic AEs after 3DCRT (vs IMRT) (both P < .01). Among 574 (87%) patients evaluable for QoL, 494 received 3DCRT and 80 IMRT. During treatment, 37.5% (vs 28.6%) reported diarrhea after 3DCRT (vs IMRT) (P = .125); 22.1% (versus 10.0%) bowel urgency (P = 0039), and 18.2% and 8.6% abdominal cramps (P = .058). Other QoL scores showed no differences. CONCLUSIONS: IMRT resulted in fewer grade ≥3 AEs during treatment and significantly lower rates of grade ≥2 diarrhea and hematologic AEs during follow-up. Trends toward fewer patient-reported bowel urgency and abdominal cramps were observed after IMRT compared to 3DCRT.
PURPOSE: Radiation therapy techniques have developed from 3-dimensional conformal radiation therapy (3DCRT) to intensity modulated radiation therapy (IMRT), with better sparing of the surrounding normal tissues. The current analysis aimed to investigate whether IMRT, compared to 3DCRT, resulted in fewer adverse events (AEs) and patient-reported symptoms in the randomized PORTEC-3 trial for high-risk endometrial cancer. METHODS AND MATERIALS: Data on AEs and patient-reported quality of life (QoL) of the PORTEC-3 trial were available for analysis. Physician-reported AEs were graded using Common Terminology Criteria for Adverse Events v3.0. QoL was assessed by the European Organisation for Research and Treatment of Cancer QLQC30, CX24, and OV28 questionnaires. Data were compared between 3DCRT and IMRT. A P value of ≤ .01 was considered statistically significant due to the risk of multiple testing. For QoL, combined scores 1 to 2 ("not at all" and "a little") versus 3 to 4 ("quite a bit" and "very much") were compared between the techniques. RESULTS: Of 658 evaluable patients, 559 received 3DCRT and 99 IMRT. Median follow-up was 74.6 months. During treatment no significant differences were observed, with a trend for more grade ≥3 AEs, mostly hematologic and gastrointestinal, after 3DCRT (37.7% vs 26.3%, P = .03). During follow-up, 15.4% (vs 4%) had grade ≥2 diarrhea, and 26.1% (vs 13.1%) had grade ≥2 hematologic AEs after 3DCRT (vs IMRT) (both P < .01). Among 574 (87%) patients evaluable for QoL, 494 received 3DCRT and 80 IMRT. During treatment, 37.5% (vs 28.6%) reported diarrhea after 3DCRT (vs IMRT) (P = .125); 22.1% (versus 10.0%) bowel urgency (P = 0039), and 18.2% and 8.6% abdominal cramps (P = .058). Other QoL scores showed no differences. CONCLUSIONS: IMRT resulted in fewer grade ≥3 AEs during treatment and significantly lower rates of grade ≥2 diarrhea and hematologic AEs during follow-up. Trends toward fewer patient-reported bowel urgency and abdominal cramps were observed after IMRT compared to 3DCRT.
Authors: Matthew Chan; Robert Olson; Vincent Lapointe; Jeremy Hamm; Francois Bachand; Caroline Holloway; Christina Parsons; Peter Lim Journal: Curr Oncol Date: 2022-05-05 Impact factor: 3.109
Authors: Marc Vogel; Jonas Gade; Bernd Timm; Michaela Schürmann; Hendrik Auerbach; Frank Nüsken; Christian Rübe; Patrick Melchior; Yvonne Dzierma Journal: Front Oncol Date: 2022-07-27 Impact factor: 5.738