Search

Endometrial cancer is the 4th most common cancer in females in India as per 2020 report from National Cancer Registry Programme (NCRP). Incidence of endometrial cancer in India is 105.5 per 100,000 women with highest being observed in Bangalore and Delhi. Management of endometrial cancer remains a challenge due to an older age population with considerable comorbidity. Surgery with or without adjuvant therapy is the standard of care in endometrial cancer, whereas upfront combination of external beam radiotherapy (EBRT) and HDR (High Dose Rate) brachytherapy (BT) or BT alone is indicated for inoperable or unresectable cases. Twenty two patients with inoperable or unresectable endometrial cancer were treated with upfront radiotherapy from 2015 to 2021. Eighteen patients received EBRT followed by HDR BT as Intracavitary radiotherapy (ICR) with Central Vaginal Cylinder (CVC), while four patients received HDR BT as monotherapy. Definitive radiotherapy was given in the form of EBRT 50 Gy in 25 fractions, 5 fractions/week followed by HDR BT as CT based ICR plus CVC, 7.5Gy per fraction, 2 fractions, 1 week apart. Outcomes were analysed retrospectively in terms of Cancer Specific Survival (CSS), Overall survival(OS) and Local control (LC). Kaplan Meire estimates of OS and PFS were determined using SPSS IBM Software version 26.0. Median age of presentation was 56.5 years (IQR: 45-74 years) and median Body mass index (BMI) was 28.48 (range 20.56-49.12). For the entire cohort, median follow up was 15.5 months (range 6-74). The mean CSS was 45.11 months (range- 28-62.19). The overall mean survival time of the study population was 46.34 months (range 27.71-64.98), with a survival rate of 75% at 2 years. The mean progression free survival was 49.22 months (range-32.26-66.19) and 2 years local control rate was 100%. No acute grade 3 and late grade 3 genitourinary or gastrointestinal toxicities were noted. Upfront radiotherapy is tolerated well among inoperable endometrial cancer patients, also including high risk patients with favorable local control and improved overall survival. [ABSTRACT FROM AUTHOR]