Projects

Background: Adjuvant external beam radiotherapy (EBRT) is a standard of care for all
patients with intermediate and high-risk uterine carcinomas. In EBRT, target volume includes
tumour bed along with pelvic lymph nodes. However, benefit of nodal irradiation in patients
with negative nodes after an adequate pelvic lymph node dissection is unclear. This
retrospective study aims to analyse outcome of limited pelvic radiotherapy (LPRT) in
postoperative carcinoma of cervix and endometrium.
Materials and methods: All postoperative carcinoma of cervix and endometrium cases
treated with adjuvant LPRT from January 2013 to December 2023 were included in the
analysis. Patients were treated to a dose of 5040 cGy using 3-Dimensional Conformal
Radiotherapy (3DCRT). In patients with cervical stroma involvement, along with an EBRT
dose of 4500 cGy, high dose rate (HDR) brachytherapy was also delivered. We plan to
analyse patterns of failure, overall survival (OS), recurrence-free survival (RFS), and
treatment-associated toxicities.
Results: Out of 391 screened postoperative carcinoma cervix and endometrium patients, 37
received LPRT. With a median follow-up of 51.1 months, 2 patients were lost to follow-up.
The 5-year RFS and OS was 75.5% and 73.2%, respectively. Among 4 patients who
developed recurrence during the 5-year analysis period, all had distant recurrences. Grade ≥ 2
gastrointestinal and genitourinary toxicities were observed in 29.7% of patients in acute
phase and 2.7% as late effects. Lymphedema occurred in 8.1%, with no Grade 4 or 5
toxicities reported.
Conclusions: LPRT without lymph node irradiation results in good local control in the
selected group of post operative uterine carcinomas