(P144) Radiation-Associated Toxicities in Obese Women With Endometrial Cancer: More Than Just BMI?

Publication
Article
OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

The impact of obesity on adjuvant treatment is poorly understood. Increasing BMI was associated with increased frequency of gynecologic and cutaneous radiation-associated toxicities. Additional studies to critically evaluate the radiation treatment dosing and treatment fields in obese EC patients are warranted to identify strategies to mitigate the radiation-associated toxicities in these women.

Savita Dandapani, MD, PhD, Ying Zhang, MD, Richard Jennelle, MD, Yvonne Lin, MD; City of Hope; USC

PURPOSE: The current study characterizes the impact of obesity on postoperative radiation-associated toxicities in women with endometrial cancer (EC).

MATERIALS AND METHODS: A retrospective cohort study identified 96 women with EC referred to a large urban institution’s radiation oncology practice for postoperative whole-pelvic radiotherapy (WPRT) and/or intracavitary vaginal brachytherapy (ICBT). Demographic, clinicopathologic, and patient-reported toxicity data were obtained from medical records. Anthropometric information, including body mass index (BMI), was collected from nursing intake records at each clinic visit. Radiation-related toxicities were graded according to Radiation Therapy Oncology Group (RTOG) Acute Radiation Morbidity Scoring Criteria. The follow-up period ranged from 1 month to 11 years (median 2 yr). The data were analyzed by chi-square, logistic regression, and recursive partitioning analyses.

RESULTS: A total of 68 evaluable EC patients who received WPRT and/or ICBT were included in the primary analysis. The median age was 52 years (range: 29–73 yr). The majority of patients were Hispanic (48, 71%), with 6 (9%) Caucasian, 1 (1%) African-American, and 13 (19%) Asian. The median BMI at diagnosis was 34.5 kg/m2 (range: 20.5–56.6 kg/m2). A total of 58 patients (85%) had abdominal hysterectomies, and 10 (15%) had laparoscopic hysterectomies; 43(63%) had a pelvic lymphadenectomy, and 15 (22%) had para-aortic lymphadenectomies. BMI was independently associated with reported radiation-related cutaneous toxicities (P = .022) and gynecologic toxicities (P = .027). Younger women also reported more gynecologic toxicities (P = .039). Adjuvant radiation technique was associated with increased gastrointestinal- and genitourinary-related toxicities but not gynecologic toxicity. There was no association of International Federation of Gynecology and Obstetrics (FIGO) stage, use of adjuvant chemotherapy, or hysterectomy type with reported radiation toxicities.

CONCLUSIONS: The impact of obesity on adjuvant treatment is poorly understood. Increasing BMI was associated with increased frequency of gynecologic and cutaneous radiation-associated toxicities. Additional studies to critically evaluate the radiation treatment dosing and treatment fields in obese EC patients are warranted to identify strategies to mitigate the radiation-associated toxicities in these women.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
Related Videos
Paolo Tarantino, MD, highlights strategies related to screening and multidisciplinary collaboration for managing ILD in patients who receive T-DXd.
Data from the REVEAL study affirm elevated white blood cell counts and higher variant allele frequency as risk factors for progression in polycythemia vera.
Additional analyses of patient-reported outcomes and MRD status in the QuANTUM-First trial are also ongoing, says Harry P. Erba, MD, PhD.
Investigators must continue to explore the space for lisocabtagene maraleucel in mantle cell lymphoma, according to Manali Kamdar, MD.
Those with CML should discuss adverse effects such as nausea or fatigue with their providers to help optimize their quality of life during treatment.
Patients with CML can become an active part of their treatment plan by discussing any questions that come to mind with their providers.
Jorge E. Cortes, MD, emphasizes proper communication between patients with chronic myeloid leukemia and their providers during the treatment course.
Dietary interventions or other medications may help mitigate diarrhea in patients who undergo therapy for chronic myeloid leukemia.
Whether CAR T-cell therapy or T-cell engagers should dominate the multiple myeloma landscape may be hard to determine, says David S. Siegel, MD.
Next steps for research in the multiple myeloma space may include the development of novel CAR T-cell strategies and bispecific antibodies.
Related Content