Prognostic factors in patients receiving palliative radiotherapy for female genital tract cancer
Kombathula, S. H. Cree, Anthea Joshi, P. V. Akturk, N Barraclough, Lisa H Haslett, Kate Choudhury, Ananya Hoskin, Peter J
Kombathula, S. H.
Cree, Anthea
Joshi, P. V.
Akturk, N
Barraclough, Lisa H
Haslett, Kate
Choudhury, Ananya
Hoskin, Peter J
Citations
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Abstract
Purpose or Objective
The 5 year survival of female genital tract cancer (FGTC) is approximately 15%. In the management of advanced female
genital tract cancer (FGTC), palliative radiotherapy plays an important role. There is little data reporting the outcome of
palliative radiotherapy in this setting and the quality of evidence available for prognostic indicators to inform patient
selection is suboptimal.
Materials and Methods
Data of patients receiving palliative radiotherapy for FGTC was collected retrospectively including patient demographics,
disease and treatment characteristics from two UK cancer centres. Overall survival was calculated from the date of
completion of radiotherapy using the Kaplan Meier method. Descriptive statistics were used for quantitative variables. The
association between the patient, disease and, treatment factors and the survival after completion of radiotherapy was
analysed using ANOVA with a significance threshold of p=0.05.
Results
A total of 184 patients were included in the study. Table-1 shows baseline patient demographics. Of all patients, 35.3%
received prior radical treatment for FGTC and then subsequently relapsed. The radiotherapy schedules used varied
significantly and ranged from 10Gy/1# to more protracted regimens like 50Gy/20# but the most commonly used regimen
was 35Gy/15#(33.6%). The prescribed regimens were well tolerated with only 1.7% unable to complete the planned course
of palliative radiotherapy. Most patients (40.7%) did not experience acute toxicity related to palliative radiotherapy, however, grade 3 acute toxicity was noted in 8.1% of the patients. After completion of palliative radiotherapy, 70.6% had
a subjective response and 34.2% went on to have further cancer-directed treatment.
The median survival after radiotherapy is 6 months and ranged from 1 month to 6 years. Upon analysis of the prognostic
factors, the absence of distant metastases (p=0.019) and receipt of further lines of treatment (p=0.045) were found to have
a positive influence on the survival after radiotherapy. Qualitative variables like performance status, comorbidities (ACE 27) and quantitative variables like EQD2 of the radiotherapy schedule, number of metastases or visceral metastases did not
significantly associate with survival post palliative radiotherapy. Conclusion
Palliative radiotherapy to the pelvis in advanced FGTC is well tolerated with a majority having a subjective response.
Patients with distant metastases who could not receive further lines of oncologic treatment fared significantly poorly. With
limited life expectancy in these patients, choice of radiotherapy schedule is key when balancing symptoms and pelvic
disease control.
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Kombathula SH, Cree A, Joshi PV, Akturk N, Barraclough LH, Haslett K, et al. Prognostic factors in patients receiving palliative radiotherapy for female genital tract cancer. Radiotherapy and Oncology. 2022 May;170:S1143-S4. PubMed PMID: WOS:000806779900171.