Radiation-Associated Toxicities in Obese Women with Endometrial Cancer: More Than Just BMI?

الملخص EN

Purpose.

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

Material and Methods.

A retrospective 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 and clinicopathologic data were obtained.

Toxicities were graded according to RTOG Acute Radiation Morbidity Scoring Criteria.

Follow-up period ranged from 1 month to 11 years (median 2 years).

Data were analyzed by χ2, logistic regression, and recursive partitioning analyses.

Results.

68 EC patients who received WPRT and/or ICBT were analyzed.

Median age was 52 years (29–73).

The majority were Hispanic (71%).

Median BMI at diagnosis was 34.5 kg/m2 (20.5–56.6 kg/m2).

BMI was independently associated with radiation-related cutaneous (p=0.022) and gynecologic-related (p=0.027) toxicities.

Younger women also reported more gynecologic-related toxicities (p=0.039).

Adjuvant radiation technique was associated with increased gastrointestinal- and genitourinary-related toxicities but not gynecologic-related toxicity.

Conclusions.

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.