Asset Details
Do you wish to reserve the book?
2022-RA-450-ESGO Benefit of adjuvant radiotherapy depends on molecular class of early-stage endometrial cancer
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
2022-RA-450-ESGO Benefit of adjuvant radiotherapy depends on molecular class of early-stage endometrial cancer
Do you wish to request the book?
2022-RA-450-ESGO Benefit of adjuvant radiotherapy depends on molecular class of early-stage endometrial cancer
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
2022-RA-450-ESGO Benefit of adjuvant radiotherapy depends on molecular class of early-stage endometrial cancer
2022
Overview
Introduction/BackgroundThe endometrial cancer (EC) molecular class is predictive for response to chemotherapy. Little is known about its’ predictive value for response to radiotherapy. We investigated benefit of adjuvant vaginal brachytherapy (VBT) and external beam radiotherapy (EBRT) across the four molecular classes.MethodologyParticipants of the randomized PORTEC-1 (n=714) and PORTEC-2 (n=427) trials were eligible if their EC were molecularly profiled according to the WHO 2020 classification. PORTEC-1 included intermediate risk EC and compared EBRT to no adjuvant treatment. PORTEC-2 included high-intermediate risk EC and compared VBT to EBRT. Locoregional recurrence-free survival (LRFS) was estimated and compared using Kaplan-Meier’s methodology and log-rank tests. Correction for confounding by predefined clinicopathological factors was done using Cox proportional hazards models.Abstract 2022-RA-450-ESGO Table 1Multivariable analysis of predictors of locoreginal recurrence-free survivalAbstract 2022-RA-450-ESGO Figure 1Results881 patients with a median follow-up of 11.3 years were included. Patient and tumour characteristics are presented in table 1. EC were classified as POLE-mutant (POLEmut, 7.3%) mismatch-repair deficient (MMRd, 28.0%), p53-abnormal (p53abn, 9.1%) and non-specific molecular profile (NSMP, 55.6%). Overall, adjuvant radiotherapy significantly improved LRFS (figure 1A). In POLEmut EC no LR were observed (figure 1B). In MMRd EC, VBT and EBRT did not significantly improve LRFS (figure 1C). In p53abn EC, EBRT but not VBT significantly improved LRFS (figure 1D). In NSMP EC, both EBRT and VBT significantly improved LRFS. Adjuvant radiotherapy and molecular class retained significant impact on LRFS after correction for clinicopathological risk factors (table 1).ConclusionBenefit of adjuvant radiotherapy in early-stage endometrioid EC differs between EC molecular classes. Omitting radiotherapy seems safe in early-stage POLEmut EC. Benefit of radiotherapy in MMRd EC is uncertain as only a small, non-significant reduction in LR was observed. In p53abn EC, EBRT significantly improved LRFS, in contrast to brachytherapy and no adjuvant treatment. NSMP EC seem to have a clear benefit of radiotherapy; VBT seems sufficient for locoregional tumour control.
Publisher
BMJ Publishing Group Ltd,Elsevier Inc,Elsevier Limited
Subject
