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Impact of obesity on treatment-related adverse events, disease recurrence, and survival in women with cervical carcinoma

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objectives

To review and report the influence of body mass index (BMI) on oncologic outcomes and toxicity in women treated with radiotherapy for locally advanced cervical cancer.

Methods

After obtaining institutional review board approval, we reviewed the records of patients with stage IB1 to IVB cervical cancer treated at our institution between 1983 and 2009. Eligible patients underwent definitive radiotherapy with external beam radiation therapy or chemoradiation and low dose rate (LDR) brachytherapy. Patient, tumor and treatment characteristics, treatment-induced adverse events (AEs), and treatment outcomes were reviewed and reported based on BMI category.

Results

This study identified 223 patients, consisting of stages I, II, III, and IV cervical cancer (36, 42, 16, and 6 %, respectively), and BMI categories <18.5, 18.5–24.9, 25–29.9, and >30 (8, 39, 22, and 31 %, respectively). Median follow-up was 30 months. Overweight and obese women (BMI > 25) were more likely to experience acute grade 3–4 skin AEs (p = 0.02). Underweight patients (BMI < 18.5) received higher bladder point radiation dose (p = 0.04) and had shorter distance between the bladder point and the point of maximum dose (p = 0.02). Women with BMI ≥30 had increased overall survival (OS) (multivariate hazard ratio [HR] 0.471, 95 % confidence interval [CI] 0.263–0.841, p = 0.01) and progression-free survival (PFS) (HR 0.513, 95 % CI 0.305–0.862, p = 0.01).

Conclusions

Treatment-related outcomes differed based on patient BMI. Future prospective studies are justified to identify whether interventions such as image-guided and adaptive treatment planning and intensity-modulated radiation therapy (IMRT) are effective in reducing treatment-related AEs for obese and underweight patients.

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Authors and Affiliations

  1. Department of Radiation Oncology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 251 E. Huron St, LC-178, Chicago, IL, 60611, USA

    Jeffrey P. Gross, Jonathan B. Strauss & Eric D. Donnelly

  2. Department of Obstetrics and Gynecology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 250 E. Superior Street, Suite 03-2303, Chicago, IL, 60611, USA

    John Lurain & Emily Berry

  3. Gynecologic Cancer Institute of Chicago, Oak Lawn, IL, USA

    Nikki Neubauer

  4. Department of Preventative Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA

    Irene Helenowski

Authors
  1. Jeffrey P. Gross
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  2. Jonathan B. Strauss
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  3. John Lurain
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  4. Emily Berry
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  5. Nikki Neubauer
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  6. Irene Helenowski
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  7. Eric D. Donnelly
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Corresponding author

Correspondence to Eric D. Donnelly.

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Compliance with ethical standards

This article does not contain any studies with human or animals subjects performed by any of the authors.

Funding sources

No funding support is associated with this study.

Conflict of interest

The authors declare that they have no competing interests.

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Gross, J.P., Strauss, J.B., Lurain, J. et al. Impact of obesity on treatment-related adverse events, disease recurrence, and survival in women with cervical carcinoma. J Radiat Oncol 5, 197–203 (2016). https://doi.org/10.1007/s13566-016-0243-x

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  • DOI: https://doi.org/10.1007/s13566-016-0243-x

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