IMRT lowers lymphedema, toxicity risks in patients with cervical cancer

Intensity-modulated radiation therapy (IMRT) helps reduce the risk of acute gastrointestinal toxicity, late genitourinary toxicity, and lower-extremity lymphedema (LEL) in patients with cervical cancer who underwent postoperative pelvic radiation therapy (PORT), a study has shown.

A team of investigators reviewed the medical records of 177 cervical cancer patients undergoing radical surgery and PORT. They administered IMRT and 3-dimensional conformal radiation therapy (3D-CRT) in 93 and 84 patients, respectively, and conducted follow-up as well as toxicity assessments.

A significant difference between the IMRT and 3D-CRT groups (median 59 vs 112 months; p<0.0001) was observed over a median follow-up period of 63 months. However, patients who underwent IMRT had a significantly lower crude incidence of acute grade 2+ (22.6 percent vs 48.1 percent; p=0.002) and 3+ gastrointestinal toxicities (3.2 percent vs 11.1 percent; p=0.04) than those on 3D-CRT.

The Kaplan-Meier estimates of late toxicities revealed reduced grade 2+ genitourinary toxicity (6.8 percent vs 15.2 percent; p=0.048) and LEL (3.1 percent vs 14.6 percent; p=0.0029) at 5 years with IMRT compared with 3D-CRT. Notably, the only significant predictor of a reduced LEL risk was IMRT.

“Lower inguinal doses may have contributed to a lower risk of developing LEL, which should be validated in future studies,” the investigators said.