Survival, Failure Patterns, and Toxicity Outcomes in Endometrial Cancer Patients Receiving Adjuvant Radiotherapy

Abstract

Objective: This study aimed to investigate the survival outcomes, recurrence patterns, and treatment-related toxicities of endometrial cancer (EC) patients who underwent adjuvant radiotherapy. Materials and Methods: Between January 2012 and December 2021, one hundred fourteen patients who underwent adjuvant radiotherapy with the diagnosis of endometrial cancer were retrospectively analyzed. Cases were evaluated for overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), cancer-specific survival (CSS), and distant metastasis-free survival (DMFS). Results: Median follow-up was 63 months (8 -135). At 5 years OS, DFS, LRFS, CSS, and DMFS were 85.5%, 90.5%, 98.9%, 94.1%, and 90.5%, respectively. Univariate analysis of lymphovascular space invasion (LVSI) is statistically significant for DFS, DMFS, and CSS, respectively (p=0.019, p=0.019, p=0.021) and histology, tumor grade, stage were statistically significant for LRFS, respectively (p=0.031, p=0.010, p=0.049). Grade 1 and 2 acute gastrointestinal toxicity were observed in 40 patients (35.1%). Grade 1 acute genitourinary toxicity was observed in 35 patients (30.7%). Grade 3 late genitourinary and gastrointestinal toxicity was observed in 0.9% and 1.8%, respectively. Conclusion: Histology, grade, LVSI, and stage didn’t significantly affect overall survival, but LVSI and stage were the most influential prognostic factors on relapse patterns. Adjuvant radiotherapy is safe and well tolerated by patients with endometrial cancer with acceptable toxicity.