Gynecological Cancer

PV 04 - Poster Viewing Q&A - Session 4

TU_43_2797 - Patient Reported Outcomes and Adverse Events of Adjuvant Radiotherapy for Uterine Cancer

Tuesday, September 17
2:45 PM - 4:00 PM
Location: ASTRO Innovation Hub

Patient Reported Outcomes and Adverse Events of Adjuvant Radiotherapy for Uterine Cancer
K. Aziz1, A. E. Garda2, T. C. Mullikin2, B. J. Stish2, M. G. Haddock2, and I. A. Petersen2; 1Mayo Clinic Medical Scientist Training Program, Rochester, MN, 2Department of Radiation Oncology, Mayo Clinic, Rochester, MN

Purpose/Objective(s): To report prospectively collected physician-reported adverse events (AEs) and patient reported outcomes (PRO) for patients treated with adjuvant radiation therapy (RT) for uterine cancer.

Materials/Methods: Patients with uterine malignancies treated with curative-intent RT at our institution between 2014 and 2018 were identified. For inclusion in this analysis, histologic confirmation of uterine malignancy, receipt of adjuvant external beam RT, and completion of baseline and post-treatment questionnaires were required. Physician-reported AEs were prospectively assessed prior to, immediately upon completion of RT, and 3 months post-RT using CTCAE Version 4.0. Patients were enrolled on a prospective PRO registry to assess quality of life using a gynecologic specific subset of the PRO-CTCAE designed to assess symptom impact on daily living.

Results: 77 patients met inclusion criteria. 71% of patients received chemotherapy prior to RT, 5.8% of patients received concurrent chemotherapy and 39.5% of patients received chemotherapy following RT. Median RT dose delivered was 4760 cGy (range 4500-6600 cGy). 73% patients underwent vaginal cuff brachytherapy (1000-2000 cGy in 2-4 fractions). There were no grade 3, 4, or 5 AEs. There were 96 grade 1 and 2 AEs: gastrointestinal (67.5%), urinary (19.5%), constitutional (24.7%), gynecologic (9%) and dermatologic (5.2%). At 3 months, 9 grade 1 and 2 toxicities were reported: gynecologic (1.3%), lymph (3.9%), gastrointestinal (2.6%), constitutional (2.6%) and urinary (1.3%). PRO-CTCAE was completed by 36 patients. PRO data were collected on a 5 point scale with score of 3-5 considered high toxicity: occasionally, frequently or almost constantly; somewhat, quite a bit or very much; moderate, severe or very severe. Proportions of patients with high toxicity scores are reported in the table below. Results showed minimal compromise in quality of life at end of treatment and 3 month post-RT in comparison to baseline function. Most symptoms reported at the end of treatment resolved within 3 months.

Conclusion: Adjuvant radiation therapy is well tolerated in patients with uterine cancer with minimal acute toxicity and resolution of most patient reported symptoms at 3 months.
Symptom Baseline (%) End of RT(%) 3 Months Post-RT (%)
Diarrhea 19 58 21
Flatulence 52 49 46
Bowel incontinence 17 19 10
Urinary frequency 30 61 34
Urinary urgency 17 37 24
Urinary incontinence 6 11 18
Pain with urination 0 11 0
Vaginal dryness 13 6 11
Fatigue 33 28 34
Pain 17 10 10

Author Disclosure: K. Aziz: None. A.E. Garda: None. T.C. Mullikin: None. M.G. Haddock: Board Member; ISIORT. Stock ownership, no oncologic products; Amarin. I.A. Petersen: Co-chair Radiation Oncology Committee; NRG Oncology.

Khaled Aziz, MS, BS

Mayo Clinic Alix School of Medicine

Biography:
Khaled Aziz is a MSTP student at Mayo Clinic school of medicine. His clinical research focuses on toxicity outcomes after radiation therapy in various malignancies and doctoral dissertation focused on chromosomal instability. Previously, he studied oxidatively induced complex DNA damage as an undergraduate student at East Carolina University. He was previously employed as a research technologist at Johns Hopkins Department of Radiation Oncology studying epithelial mesenchymal transition and mechanisms of radiation sensitization. His passion outside of aademics are running and soccer.

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