Abstract
Background and purpose Postoperative radiotherapy in endometrial cancer reduces the risk of local relapse but is also associated with substantial acute and late reactions. The aim of our study was to evaluate time without tumor symptoms and toxicity (TWIST) in a consecutive series of 317 endometrial cancer patients administered postoperative irradiation. Patients and methods Both low-dose rate brachytherapy (BRT) and external beam irradiation (EBRT) were applied in 247 patients (78%), only BRT - in 49 (15%) and only EBRT - in 21 patients (7%). Median follow-up was 7.3 years (range, 4-21 years). TWIST analysis based on actuarial freedom from recurrent disease and from late radiotherapy effects was performed with the use of Kaplan-Meier method. The impact of patient- and treatment-related factors on TWIST was assessed with uni- and multivariate tests. Results Five-year overall survival was 78%, and five-year disease free survival - 75%. Recurrence occurred in 70 patients (22%), of whom in 11 (3.5%) - exclusively in the pelvis. Acute and late reactions of any grade occurred in 268 (85%) and 158 patients (51%), respectively. Late bowel effects of any grade were observed in 41% of patients. Severe late effects occurred in 35 patients (11%). Actuarial probability of two- and five-year survival free of disease and severe (grades 3 or 4) late effects (TWIST) was 84% and 71%, respectively (median TWIST, 16.2 years). When all-grade late effects were considered, two- and five-year TWIST probability was 50 and 30%, respectively, and median TWIST was only 2.0 years. When both acute and late reactions were taken into account, median TWIST was 22 months. In unifactorial test, higher age (P=0.013), FIGO stage (P
| Original language | English |
|---|---|
| Pages (from-to) | 175-181 |
| Number of pages | 7 |
| Journal | Radiotherapy and Oncology |
| Volume | 72 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Aug 2004 |
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Keywords
- Acute and late reactions
- Adjuvant radiotherapy
- Endometrial cancer
- Quality of life
- Recurrent disease
- Time without tumor symptoms and toxicity
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Urology
Cite this
Time without symptoms and toxicity (TWIST) analysis of adjuvant radiation therapy for endometrial cancer. / Jereczek-Fossa, Barbara A.; Badzio, Andrzej; Jassem, Jacek.
In: Radiotherapy and Oncology, Vol. 72, No. 2, 08.2004, p. 175-181.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Time without symptoms and toxicity (TWIST) analysis of adjuvant radiation therapy for endometrial cancer
AU - Jereczek-Fossa, Barbara A.
AU - Badzio, Andrzej
AU - Jassem, Jacek
PY - 2004/8
Y1 - 2004/8
N2 - Background and purpose Postoperative radiotherapy in endometrial cancer reduces the risk of local relapse but is also associated with substantial acute and late reactions. The aim of our study was to evaluate time without tumor symptoms and toxicity (TWIST) in a consecutive series of 317 endometrial cancer patients administered postoperative irradiation. Patients and methods Both low-dose rate brachytherapy (BRT) and external beam irradiation (EBRT) were applied in 247 patients (78%), only BRT - in 49 (15%) and only EBRT - in 21 patients (7%). Median follow-up was 7.3 years (range, 4-21 years). TWIST analysis based on actuarial freedom from recurrent disease and from late radiotherapy effects was performed with the use of Kaplan-Meier method. The impact of patient- and treatment-related factors on TWIST was assessed with uni- and multivariate tests. Results Five-year overall survival was 78%, and five-year disease free survival - 75%. Recurrence occurred in 70 patients (22%), of whom in 11 (3.5%) - exclusively in the pelvis. Acute and late reactions of any grade occurred in 268 (85%) and 158 patients (51%), respectively. Late bowel effects of any grade were observed in 41% of patients. Severe late effects occurred in 35 patients (11%). Actuarial probability of two- and five-year survival free of disease and severe (grades 3 or 4) late effects (TWIST) was 84% and 71%, respectively (median TWIST, 16.2 years). When all-grade late effects were considered, two- and five-year TWIST probability was 50 and 30%, respectively, and median TWIST was only 2.0 years. When both acute and late reactions were taken into account, median TWIST was 22 months. In unifactorial test, higher age (P=0.013), FIGO stage (P
AB - Background and purpose Postoperative radiotherapy in endometrial cancer reduces the risk of local relapse but is also associated with substantial acute and late reactions. The aim of our study was to evaluate time without tumor symptoms and toxicity (TWIST) in a consecutive series of 317 endometrial cancer patients administered postoperative irradiation. Patients and methods Both low-dose rate brachytherapy (BRT) and external beam irradiation (EBRT) were applied in 247 patients (78%), only BRT - in 49 (15%) and only EBRT - in 21 patients (7%). Median follow-up was 7.3 years (range, 4-21 years). TWIST analysis based on actuarial freedom from recurrent disease and from late radiotherapy effects was performed with the use of Kaplan-Meier method. The impact of patient- and treatment-related factors on TWIST was assessed with uni- and multivariate tests. Results Five-year overall survival was 78%, and five-year disease free survival - 75%. Recurrence occurred in 70 patients (22%), of whom in 11 (3.5%) - exclusively in the pelvis. Acute and late reactions of any grade occurred in 268 (85%) and 158 patients (51%), respectively. Late bowel effects of any grade were observed in 41% of patients. Severe late effects occurred in 35 patients (11%). Actuarial probability of two- and five-year survival free of disease and severe (grades 3 or 4) late effects (TWIST) was 84% and 71%, respectively (median TWIST, 16.2 years). When all-grade late effects were considered, two- and five-year TWIST probability was 50 and 30%, respectively, and median TWIST was only 2.0 years. When both acute and late reactions were taken into account, median TWIST was 22 months. In unifactorial test, higher age (P=0.013), FIGO stage (P
KW - Acute and late reactions
KW - Adjuvant radiotherapy
KW - Endometrial cancer
KW - Quality of life
KW - Recurrent disease
KW - Time without tumor symptoms and toxicity
UR - http://www.scopus.com/inward/record.url?scp=3543088548&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=3543088548&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2004.04.006
DO - 10.1016/j.radonc.2004.04.006
M3 - Article
C2 - 15297136
AN - SCOPUS:3543088548
VL - 72
SP - 175
EP - 181
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 2
ER -