방사선의학 웹진

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Abstract
Objective: This study evaluates the safety and efficacy of hypofractionated intensity-modulated radiation therapy (IMRT) following radical hysterectomy.

Methods: This phase II, non-randomized multicenter trial included 61 patients with cervical cancer who were eligible for adjuvant RT after radical hysterectomy. Participants received 40 Gy in 16 fractions using IMRT to whole pelvis. The primary endpoint was the incidence of grade 3 or higher acute gastrointestinal, genitourinary, and hematologic toxicities. Secondary endpoints included patient-reported quality of life and disease-free survival (DFS). Acute toxicities were monitored using the National Cancer Institute's Common Terminology Criteria for Adverse Events v4.0.

Results: Among the participants, the incidence of grade 3 or higher acute toxicities was 1.6 % (90 % confidence interval, 0-3.7 %). After a median follow-up of 39.5 months, the 3-year DFS rate was 87.1 %, and no grade ≥ 3 late toxicities were reported during the follow-up period.

Conclusion: Hypofractionated IMRT post-radical hysterectomy demonstrated low severe toxicity rates and effective disease control, suggesting a feasible alternative to conventional fractionation. However, further randomized comparative trials are required to validate the results of this study.

Trial registration: Registered on ClinicalTrials.gov, NCT03239626.

Affiliations

Won Kyung Cho 1, Won Park 2, Sang-Won Kim 3, Kang Kyu Lee 4, Ki Jung Ahn 5, Meesun Yoon 6, Jin Hwa Choi 7
1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: wonro.park@samsung.com.
3Department of Radiation Oncology, Konyang University College of Medicine, Daejeon, Republic of Korea.
4Department of Radiation Oncology, Wonkwang University School of Medicine, Iksan, Republic of Korea.
5Department of Radiation Oncology, Inje University Busan Paik Hospital, Busan, Republic of Korea.
6Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University College of Medicine, Kwang-Ju, Republic of Korea.
7Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Republic of Korea.