Rosa Autorino, Raffaella Michela Rinaldi, Gabriella Macchia, Mariangela Boccardi, Inga Mihoci Roshanian, Rita Sebastiani, Bianca Santo, Donatella Russo, Martina Ferioli, Anna Benini, Elisabetta Perrucci, Arcangela Raguso, Sabrina Cossa, Paolo Matteucci, Claudia Talocco, Lisa Vicenzi, Fabio Trippa, Lorena Draghini, Antonietta Augurio, Fiorella Cristina Di Guglielmo, Paola Cocuzza, Francesca Pistis, Francesca De Felice, Sofia Meregalli, Elisa Maria Bonetto, Maria Tamburo, Vittorio Bini, Andrea Vavassori, Maria Antonietta Gambacorta, Cynthia Aristei
{"title":"女士项目：用于个性化治疗的大型子宫内膜癌数据库。","authors":"Rosa Autorino, Raffaella Michela Rinaldi, Gabriella Macchia, Mariangela Boccardi, Inga Mihoci Roshanian, Rita Sebastiani, Bianca Santo, Donatella Russo, Martina Ferioli, Anna Benini, Elisabetta Perrucci, Arcangela Raguso, Sabrina Cossa, Paolo Matteucci, Claudia Talocco, Lisa Vicenzi, Fabio Trippa, Lorena Draghini, Antonietta Augurio, Fiorella Cristina Di Guglielmo, Paola Cocuzza, Francesca Pistis, Francesca De Felice, Sofia Meregalli, Elisa Maria Bonetto, Maria Tamburo, Vittorio Bini, Andrea Vavassori, Maria Antonietta Gambacorta, Cynthia Aristei","doi":"10.1007/s11547-024-01940-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare Italian use with current international guidelines and to evaluate oncological outcomes and toxicity patterns of adjuvant radiation therapy (RT) for endometrial cancer (EC) in Italian women.</p><p><strong>Materials and methods: </strong>To conduct a retrospective multicentre Italian study a large database was set up. Inclusion criteria were: accrual between 2010 and 2020, treatment with surgery, post-operative external beam RT (EBRT) and/or interventional radiotherapy (IRT) associated or not with adjuvant chemotherapy. Oncological outcomes, acute and late toxicities were analysed according to RT schedule and risk group.</p><p><strong>Results: </strong>A total of 1848 patients, from 16 Italian RT centres were enrolled (median age 65 years, range 27-88). All patients received post-operative RT associated with chemotherapy in 31%. Patients were stratified on the basis of standard risk factors (Bosse et al. in Eur J Cancer 51:1742-50, 2015). After merging intermediate and high-intermediate risk classes into one intermediate group and including advanced and oligometastatic disease in the high-risk group, the low-risk group encompassed 124 patients, the intermediate-risk 1140, and the high risk 576. No low-risk patient developed local relapse (LR). Multivariate analysis showed that intermediate risk patients had a 2.5-fold increased risk of LR if treated with IRT alone vs EBRT-IRT boost. RT schedule did not impact significantly on LR in high risk patients. All acute toxicity parameters were highest in patients who received EBRT with simultaneous integrated boost (EBRT-SIB) and lowest in patients who received only IRT (p < 0.0001). Late toxicity was highest patients who received EBRT-SIB and lowest in those who were given EBRT with sequential boost (p < 0.0001).</p><p><strong>Conclusions: </strong>This retrospective study showed that Italian administration of adjuvant RT for EC is in accordance with current international guidelines. 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引用次数: 0
摘要
目的：比较意大利与现行国际指南的使用情况，并评估意大利妇女子宫内膜癌（EC）辅助放射治疗（RT）的肿瘤学结果和毒性模式。材料和方法：为了进行一项回顾性的多中心意大利研究，建立了一个大型数据库。纳入标准为：2010年至2020年期间的累积，手术治疗，术后外束放疗（EBRT）和/或介入放疗（IRT）是否与辅助化疗相关。根据放疗计划和危险组分析肿瘤预后、急性和晚期毒性。结果：共纳入了来自16个意大利RT中心的1848例患者（中位年龄65岁，范围27-88岁）。31%的患者接受了术后放疗和化疗。根据标准危险因素对患者进行分层（Bosse et al. in Eur J Cancer 51:1742-50, 2015）。在将中度和高中度风险类别合并为一个中间组，并将晚期和低转移性疾病纳入高风险组后，低风险组包括124例患者，中度风险1140例，高风险576例。无低危患者出现局部复发（LR）。多因素分析显示，与EBRT-IRT联合治疗相比，中等风险患者单独接受IRT治疗的LR风险增加2.5倍。放疗计划对高危患者的LR无显著影响。所有急性毒性参数在接受EBRT同时综合增强（EBRT- sib）的患者中最高，而在仅接受IRT的患者中最低(p)。结论：这项回顾性研究表明，意大利对EC的辅助RT治疗符合当前的国际指南。低风险患者单独接受IRT治疗和EBRT联合阴道IRT治疗仍然是EC的标准辅助治疗方法。
Ladies project: large database in endometrial cancers for a personalized treatment.
Purpose: To compare Italian use with current international guidelines and to evaluate oncological outcomes and toxicity patterns of adjuvant radiation therapy (RT) for endometrial cancer (EC) in Italian women.
Materials and methods: To conduct a retrospective multicentre Italian study a large database was set up. Inclusion criteria were: accrual between 2010 and 2020, treatment with surgery, post-operative external beam RT (EBRT) and/or interventional radiotherapy (IRT) associated or not with adjuvant chemotherapy. Oncological outcomes, acute and late toxicities were analysed according to RT schedule and risk group.
Results: A total of 1848 patients, from 16 Italian RT centres were enrolled (median age 65 years, range 27-88). All patients received post-operative RT associated with chemotherapy in 31%. Patients were stratified on the basis of standard risk factors (Bosse et al. in Eur J Cancer 51:1742-50, 2015). After merging intermediate and high-intermediate risk classes into one intermediate group and including advanced and oligometastatic disease in the high-risk group, the low-risk group encompassed 124 patients, the intermediate-risk 1140, and the high risk 576. No low-risk patient developed local relapse (LR). Multivariate analysis showed that intermediate risk patients had a 2.5-fold increased risk of LR if treated with IRT alone vs EBRT-IRT boost. RT schedule did not impact significantly on LR in high risk patients. All acute toxicity parameters were highest in patients who received EBRT with simultaneous integrated boost (EBRT-SIB) and lowest in patients who received only IRT (p < 0.0001). Late toxicity was highest patients who received EBRT-SIB and lowest in those who were given EBRT with sequential boost (p < 0.0001).
Conclusions: This retrospective study showed that Italian administration of adjuvant RT for EC is in accordance with current international guidelines. IRT alone for low-risk patients and EBRT associated with vaginal IRT remain standard adjuvant approaches for EC.
期刊介绍：
Felice Perussia founded La radiologia medica in 1914. It is a peer-reviewed journal and serves as the official journal of the Italian Society of Medical and Interventional Radiology (SIRM). The primary purpose of the journal is to disseminate information related to Radiology, especially advancements in diagnostic imaging and related disciplines. La radiologia medica welcomes original research on both fundamental and clinical aspects of modern radiology, with a particular focus on diagnostic and interventional imaging techniques. It also covers topics such as radiotherapy, nuclear medicine, radiobiology, health physics, and artificial intelligence in the context of clinical implications. The journal includes various types of contributions such as original articles, review articles, editorials, short reports, and letters to the editor. With an esteemed Editorial Board and a selection of insightful reports, the journal is an indispensable resource for radiologists and professionals in related fields. Ultimately, La radiologia medica aims to serve as a platform for international collaboration and knowledge sharing within the radiological community.
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