Does the Type of Adjuvant Radiation Matter When Treating Elderly High-Risk Endometrial Cancer Patients with Chemotherapy and Radiation?

Does the Type of Adjuvant Radiation Matter When Treating Elderly High-Risk Endometrial Cancer Patients with Chemotherapy and Radiation? Poster ID: 271868 - National Cancer Data Base (NCDB) Study - Hysterectomy-staged patients diagnosed ≥70yrs, between 2004-2017 - High-risk endometrial cancer, defined as: - Stage IB grade 3 or stage II-III any grade EEC - Stage I-III serous/clear cell carcinoma - Adjuvant treatment with CT+VBT vs. CT+EBRT±VBT - Propensity score analysis balanced the prognostic clinical variables that varied by treatment - Survival was estimated using weighted Kaplan-Meier method. - Risk of death was estimated using weighted Cox model RESULTS Sara M. Drayer MD1,2, Collin Sitler DO1,2, Chunqiao Tian PhD1-3, Christopher M. Tarney MD1,2, Yovanni Casablanca MD4, Ann Klopp MD5, Matthew A. Powell MD6, John K. Chan MD7, Nicholas W. Bateman PhD1-3, Thomas P Conrads PhD1,2,8, G. Larry Maxwell MD1,2,8, Neil T. Phippen MD1,2, Kathleen M. Darcy PhD1-3 No. at Risk 0-mo. 12-mo. 24-mo. 36-mo. 48-mo. 60-mo. CT+EBRT±VBT 1984 1872 1537 1191 923 706 CT+VBT 1309 1265 1082 851 663 504 5-Year Survival (95% CI) Adjusted HR (95% CI) P value CT+EBRT±VBT 63.0 (59.9 – 65.9) Reference CT+VBT 67.0 (62.9 – 70.7) 0.80 (0.69 – 0.92) 0.002 BACKGROUND METHODS CONCLUSIONS Incidence and mortality in endometrial cancer are increasing, and survival outcomes are poor for patients with high-risk disease. Standard of care includes surgical staging, followed by adjuvant RT (radiation alone), CT (chemotherapy alone), or CT+RT (chemoradiotherapy). - GOG 99/PORTEC 1: utility of RT in a high-risk population - PORTEC 2: non-inferiority of VBT (vaginal brachytherapy) to EBRT (external beam) - PORTEC 3: survival benefit from CT+RT vs RT (more pronounced in individuals age > 70) - GOG 258: CT+RT equivalent to CT alone - CT+VBT is yet to be evaluated in a randomized trial - Adjuvant CT+VBT was associated with superior overall survival compared to CT+EBRT±VBT in elderly high-risk endometrial cancer pat
RITM0033329
Incidence and mortality in endometrial cancer are increasing, and survival outcomes are poor for patients with high-risk disease. Standard of care includes surgical staging, followed by adjuvant RT (radiation alone), CT (chemotherapy alone), or CT+RT (chemoradiotherapy). - GOG 99/PORTEC 1: utility of RT in a high-risk population - PORTEC 2: non-inferiority of VBT (vaginal brachytherapy) to EBRT (external beam) - PORTEC 3: survival benefit from CT+RT vs RT (more pronounced in individuals age > 70) - GOG 258: CT+RT equivalent to CT alone - CT+VBT is yet to be evaluated in a randomized trial