Cervical cancer: intensity-modulated radiotherapy is the new standard in high-risk patients


  • Deepa Koli
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

From ASTRO 2020

Takeaway

  • In patients with cervical cancer who receive radiotherapy after undergoing hysterectomy, image-guided intensity-modulated radiotherapy (IG-IMRT) significantly lowers the risk for late gastrointestinal toxicity vs 3-dimensional conformal radiotherapy (3D-CRT).
  • No difference in disease-free survival was seen between the treatments.

Why this matters

  • Results support IG-IMRT as the new standard of care for postoperative pelvic radiation therapy in this setting.

Study design

  • Final analysis of phase 3 PARCER trial.
  • 300 patients with cervical cancer underwent hysterectomy and were randomly assigned to IG-IMRT (n=151) and 3D-CRT (n=149) as part of adjuvant chemoradiotherapy.
  • Funding: Department of Atomic Energy, India; Varian International; the Terry Fox Foundation.

Key results

  • Median follow-up was 49 months.
  • At 4 years, in the IG-IMRT and 3D-CRT groups, respectively:
    • Grade ≥2 late gastrointestinal adverse event (AE) rates were 19.2% and 36.2% (HR, 0.53; P=.005).
    • Grade ≥3 late gastrointestinal AE rates were 2.0% and 8.7% (HR, 0.23; P<.01>
    • Rates of acute grade ≥2 diarrhea were 17.2% and 27.2% (P=.004).
  • No difference was seen in DFS in IG-IMRT vs 3D-CRT groups (73% vs 68%; P=.30).