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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2007 > June
External beam radiotherapy no benefit in early endometrial cancer
Megan Rauscher
Last Updated: 2007-06-05 12:05:19 -0400 (Reuters Health)
CHICAGO (Reuters Health) - In women with early-stage endometrial cancer, external beam radiation therapy (EBRT) right after surgery does not extend survival or reduce the risk of recurrence, according to a large prospective, randomized study reported here at the American Society of Clinical Oncology meeting.
"Patients with stage I endometrial cancer at high risk of relapse generally receive adjuvant EBRT following surgery, despite lack of evidence that radiotherapy improves overall survival," the researchers note in a meeting abstract.
In the current trial involving 906 women with resected early-stage endometrial cancer, 452 received EBRT (40-46 Gy in 20-25 fractions to the pelvis) after surgery and 454 received no further treatment until recurrence.
"After more than 4 years average follow up, we saw no difference in overall or recurrence-free survival between the two groups," Dr. Ann Marie Swart from the MRC Clinical Trials Unit, London, UK, reported at the conference. "Five-year overall survival was 84%, 5-year disease-specific survival was 89%, and 5-year recurrence-free survival was 78%."
Early and late toxicity was more than twice as common in the EBRT arm as in the no EBRT arm.
In a subgroup analysis, the study team sought to determine whether there is a group of very high risk women who might benefit from EBRT; "that is, women with higher grade tumors, which have spread to the outer wall of the uterus or just beyond," Dr. Swart explained. "We expected to see a benefit in these women but we didn't," she said.
They also conducted a meta-analysis to be sure they were not missing a "small but clinically important effect of EBRT," combining the current trial data with data from two similar trials for a total of 2,011 women, Dr. Swart said. From this analysis, "we can conclude that if there is a benefit to external beam radiotherapy it is very small and it can't be more than 3%."
The other "important" message from their study, Dr. Swart pointed out, is that "women with early-stage endometrial cancer have quite good outcomes without EBRT -- 89% disease-specific survival at 5 years after surgery."
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