Palliative radiotherapy in cancers of female genital tract: Outcomes and prognostic factors.


Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
10 2022
Historique:
received: 03 06 2022
revised: 27 07 2022
accepted: 28 07 2022
pubmed: 15 8 2022
medline: 21 10 2022
entrez: 14 8 2022
Statut: ppublish

Résumé

Metastatic and incurable cancers of the gynaecological tract (FGTC) represent a major global health burden. Systemic treatment has modest efficacy and radiotherapy is often used for local symptoms. This study combines experience from two large UK centres in palliative radiotherapy for gynaecological cancers. Pooled data from two major centres was analysed. Advanced FGTC patients who received at least one fraction of palliative radiotherapy to the pelvis between 2013 and 2018 were included. Data collected included demographic and tumour details, radiotherapy dose fractionation and details of previous and subsequent treatment. Response was defined in terms of toxicity, symptomatic response and survival. Comorbidities were recorded using a modified ACE 27 score which is adjusted for the presence of uncontrolled FGTC in all the patients. A total of 184 patients were included for treatment response and toxicity; survival data was available for 165 patients. Subjective response in pre-radiotherapy symptoms was documented in 80.4%. Grade 3 or worse gastrointestinal, urinary and other (vomiting, fatigue, pain) toxicity incidence was 2.2%, 3.8%, and 2.7% respectively. No statistically significant correlation between the prescribed EQD2 Palliative radiotherapy is effective for symptoms of advanced FGTC with low toxicity. The absence of a dose response argues for short low dose palliative radiotherapy schedules to be used.

Sections du résumé

BACKGROUND AND PURPOSE
Metastatic and incurable cancers of the gynaecological tract (FGTC) represent a major global health burden. Systemic treatment has modest efficacy and radiotherapy is often used for local symptoms. This study combines experience from two large UK centres in palliative radiotherapy for gynaecological cancers.
MATERIALS AND METHODS
Pooled data from two major centres was analysed. Advanced FGTC patients who received at least one fraction of palliative radiotherapy to the pelvis between 2013 and 2018 were included. Data collected included demographic and tumour details, radiotherapy dose fractionation and details of previous and subsequent treatment. Response was defined in terms of toxicity, symptomatic response and survival. Comorbidities were recorded using a modified ACE 27 score which is adjusted for the presence of uncontrolled FGTC in all the patients.
RESULTS
A total of 184 patients were included for treatment response and toxicity; survival data was available for 165 patients. Subjective response in pre-radiotherapy symptoms was documented in 80.4%. Grade 3 or worse gastrointestinal, urinary and other (vomiting, fatigue, pain) toxicity incidence was 2.2%, 3.8%, and 2.7% respectively. No statistically significant correlation between the prescribed EQD2
CONCLUSION
Palliative radiotherapy is effective for symptoms of advanced FGTC with low toxicity. The absence of a dose response argues for short low dose palliative radiotherapy schedules to be used.

Identifiants

pubmed: 35964765
pii: S0167-8140(22)04221-9
doi: 10.1016/j.radonc.2022.07.023
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

42-46

Subventions

Organisme : Department of Health
Pays : United Kingdom
Organisme : Cancer Research UK
Pays : United Kingdom

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Auteurs

Sri Harsha Kombathula (SH)

The Christie NHS Foundation Trust, Clinical Oncology, Manchester.

Anthea Cree (A)

The Christie NHS Foundation Trust, Clinical Oncology, Manchester; The Clatterbridge Cancer Centre, Clinical Oncology, Liverpool.

Priya V Joshi (PV)

Mount Vernon Cancer Centre, Clinical Oncology, Northwood, United Kingdom.

Nesrin Akturk (N)

The Christie NHS Foundation Trust, Clinical Oncology, Manchester.

Lisa H Barraclough (LH)

The Christie NHS Foundation Trust, Clinical Oncology, Manchester.

Kate Haslett (K)

The Christie NHS Foundation Trust, Clinical Oncology, Manchester.

Ananya Choudhury (A)

The Christie NHS Foundation Trust, Clinical Oncology, Manchester; Department of Cancer Sciences, University of Manchester.

Peter Hoskin (P)

The Christie NHS Foundation Trust, Clinical Oncology, Manchester; Department of Cancer Sciences, University of Manchester; Mount Vernon Cancer Centre, Clinical Oncology, Northwood, United Kingdom. Electronic address: peterhoskin@nhs.net.

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Classifications MeSH