Short-course, higher-dose vaginal brachytherapy for endometrial cancer may demonstrate comparable efficacy to more frequent, lower-dose sessions, according to a recent study published by Suneja et al in JCO Oncology Advances.
Background
Endometrial cancer is the most common cancer type of the female reproductive organs, according to the American Cancer Society. The incidence and mortality rates of the disease are currently rising.
The primary treatment for endometrial cancer is surgery to remove the uterus, cervix, and upper vagina; brachytherapy is used as a secondary treatment to prevent cancer recurrence. Patients who receive vaginal cuff brachytherapy are treated with internal radiation therapy via an applicator in the vaginal cavity.
“There isn’t high-quality data on optimal dose and schedule for brachytherapy treatments. Because of this, practice patterns really vary,” explained lead study author Gita Suneja, MD, MS, Professor of Radiation Oncology at the University of Utah (the U) and a physician-scientist at the Huntsman Cancer Institute at the U. “The SAVE trial sought to try to lower the number of treatments that patients were receiving but maintain short-term quality of life and disease control.”
Study Methods and Results
In the SAVE trial, researchers randomly assigned patients with endometrial cancer to receive different treatment doses over a varying number of sessions. The experimental group received higher doses of radiation therapy in just two sessions, whereas the control group received standard treatment, involving between three and five appointments with lower doses. The researchers discovered similar short-term outcomes and few acute toxicities between the patients in the experimental and control groups.
The findings could help improve cancer care among patients with endometrial cancer, said study authors.
“It’s [especially] hard for patients … in a rural and frontier environment like many of our patients at Huntsman Cancer Institute [to access care],” stressed Dr. Suneja. “We recognize this is an enormous burden for [patients] to come here for treatment, on top of dealing with a difficult diagnosis. We are motivated to better serve our rural population, and the results of this study will give us a way to do that,” she highlighted.
“We are very grateful for the support and the enthusiasm from our clinical colleagues at MD Anderson, Loyola, Intermountain Healthcare, and Stanford—the institutions that also participated in the SAVE trial,” noted senior study author David Gaffney, MD, PhD, FACR, FABS, FASTRO, Professor of Radiation Oncology at the U and a physician-scientist at the Huntsman Cancer Institute at the U. “We are particularly grateful for the patients that agreed to participate in the study. It is a big win when we can preserve good outcomes and make cancer care easier,” he concluded.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
