A Phase II Study of Intensity Modulated Radiation Therapy to the Pelvis for Postoperative Patients With Endometrial Carcinoma: Radiation Therapy Oncology Group Trial 0418

Journal Article · Sat Sep 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2012.02.044· OSTI ID:22149459

Jhingran, Anuja ^[1]; Winter, Kathryn ^[2]; Portelance, Lorraine ^[3]; Miller, Brigitte ^[4]; Salehpour, Mohammad ^[1]; Gaur, Rakesh ^[5]; Souhami, Luis ^[6]; Small, William ^[7]; Berk, Lawrence ^[8]; Gaffney, David ^[9]

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1. University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
2. RTOG Statistical Center, Philadelphia, Pennsylvania (United States)
3. University of Miami, Miami, Florida (United States)
4. Carolinas Medical Center North East, Concord, North Carolina (United States)
5. St. Luke's Hospital, Kansas City, Missouri (United States)
6. McGill University Health Centre, Montreal, Quebec (Canada)
7. Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illionis (United States)
8. H. Lee Moffitt Cancer Center, Tampa, Florida (United States)
9. Huntsman Cancer Hospital, Salt Lake City, Utah (United States)

Purpose: To determine the feasibility of pelvic intensity modulated radiation therapy (IMRT) for patients with endometrial cancer in a multi-institutional setting and to determine whether this treatment is associated with fewer short-term bowel adverse events than standard radiation therapy. Methods: Patients with adenocarcinoma of the endometrium treated with pelvic radiation therapy alone were eligible. Guidelines for target definition and delineation, dose prescription, and dose-volume constraints for the targets and critical normal structures were detailed in the study protocol and a web-based atlas. Results: Fifty-eight patients were accrued by 25 institutions; 43 were eligible for analysis. Forty-two patients (98%) had an acceptable IMRT plan; 1 had an unacceptable variation from the prescribed dose to the nodal planning target volume. The proportions of cases in which doses to critical normal structures exceeded protocol criteria were as follows: bladder, 67%; rectum, 76%; bowel, 17%; and femoral heads, 33%. Twelve patients (28%) developed grade {>=}2 short-term bowel adverse events. Conclusions: Pelvic IMRT for endometrial cancer is feasible across multiple institutions with use of a detailed protocol and centralized quality assurance (QA). For future trials, contouring of vaginal and nodal tissue will need continued monitoring with good QA and better definitions will be needed for organs at risk.

• OSTI ID: 22149459
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 84; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BLADDER
CARCINOMAS
FEMUR
HEALTH HAZARDS
MONITORING
PATIENTS
PELVIS
PLANNING
QUALITY ASSURANCE
RADIATION DOSES
RADIOTHERAPY
RECOMMENDATIONS
RECTUM
STANDARDS
UTERUS