Overtreatment Impacts Quality of Life

Endometrial cancer responds well to brachytherapy alone

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) After primary treatment - such as surgery - is finished, many cancer patients begin what's called adjuvant therapy. This additional treatment may include radiation, chemotherapy and/or medication. Researchers now know that adjuvant therapy can be overdone.

Women with endometrial (uterine) cancer respond well to a certain type of radiation therapy called brachytherapy. This treatment uses radioactive beads that are placed inside the body.

Adding another kind of radiation - external beam radiation - to this therapy doesn't help a woman live longer, but does have serious long-term effects.

"Ask about exactly what kind of radiation you'll be receiving."

Swedish researchers discovered that the additional radiation was not helpful. Their study involved about 525 women who were followed for a median (middle amount) of five years. They all had medium-risk cancers.

For the study, some of the women received vaginal brachytherapy (VBT) only, and some women had the brachytherapy plus external beam radiotherapy.

The researchers looked not only at the results of these treatments, but also quality-of-life issues.

Relapse rates were lower in the women who had both types of radiation - 1.5 percent, compared to 5 percent of women who had brachytherapy only.

Yet the women from both groups had nearly identical survival rates. Five years after treatment, 89 percent of the women who had only one therapy were still alive and 90 percent for those who had both types.

However, the external beam radiation was associated with more negative side effects involving the colon and urinary tract, including the bladder. The quality of life for these women declined toward the end of the radiation, but returned to normal after several months.

After measuring various symptoms and quality-of-life issues, the researchers found that VBT alone offered better overall outcomes.

They wrote, "Despite a significant locoregional control benefit with combined radiotherapy, no survival improvement was recorded; but increased late toxicity from the intestine and the bladder."

This study was published in the August issue of International Journal of Gynecological Cancer.

No financial information was available.

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Review Date: 
August 16, 2012
Last Updated:
August 17, 2012