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361 Sexual health and quality of life after molecular-based adjuvant treatment in the randomised PORTEC-4a trial
  1. Anne Sophie Van Den Heerik1,
  2. Cathalijne Post1,
  3. Ludy Lutgens2,
  4. Dorien Haverkort3,
  5. Stefan Kommoss4,
  6. Friederike Koppe5,
  7. Marlies Nowee6,
  8. Henrike Westerveld7,
  9. Marianne De Jong8,
  10. David Cibula9,
  11. Jeltsje Cnossen10,
  12. Jan Willem Mens11,
  13. Cyrus Chargari12,
  14. Charles Gillham13,
  15. Katrien Vandecasteele14,
  16. Karen Verhoeven-Adema15,
  17. Remi Nout11,
  18. Hein Putter1,
  19. Carien Creutzberg1 and
  20. Nanda Horeweg1
  1. 1Leiden University Medical Center, Leiden, The Netherlands
  2. 2Maastricht Radiation Oncology Clinic, Maastricht, The Netherlands
  3. 3Radiotherapy Group, Arnhem, The Netherlands
  4. 4University of Tübingen, Tübingen, Germany
  5. 5Institute Verbeeten, Tilburg, The Netherlands
  6. 6Netherlands Cancer Institute, Amsterdam, The Netherlands
  7. 7Amsterdam University Medical Centers, Amsterdam, The Netherlands
  8. 8Radiotherapie Instituut Friesland, Leeuwarden, The Netherlands
  9. 9First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
  10. 10Catharina Hospital, Eindhoven, The Netherlands
  11. 11Erasmus MC – Cancer Institute, Rotterdam, The Netherlands
  12. 12Institut Gustave Roussy, Villejuif, France
  13. 13St. Luke’s Hospital, Dublin, Ireland
  14. 14University Hospital Ghent, Ghent, Belgium
  15. 15Comprehensive Cancer Centre, Utrecht, The Netherlands


Introduction/Background The PORTEC-4a trial was the first to introduce molecular factors for adjuvant treatment allocation in women with early-stage high-intermediate risk endometrial cancer (HIR-EC). Here, we investigated health-related quality of life (HRQL) and sexual well-being between treatment arms.

Methodology Patients with HIR-EC were randomised (2:1) between individualised treatment based on a molecular-integrated risk profile or vaginal brachytherapy (VBT), figure 1A. HRQL and sexual outcomes were assessed (EORTC-QLQ C30 and EN24) at baseline, after treatment and 6-monthly after randomisation up to two years after randomisation and compared with age-matched normative data. A linear mixed model was used and a 2-sided p<0.01 was considered statistically significant.

Results From 2012 to 2021, 563 evaluable patients were included, 367 in the intervention-arm and 196 in the standard arm, figure 1A. Median age was 69. Both treatment groups reported similar quality of life (p=0.17) and physical (p=0.62) and role functioning (p=0.05) scores over time, which were all better than those of the age-matched normative data. In addition, no differences in emotional (p=0.37) and social (p=0.94) functioning were observed between the two arms. At baseline, 72.9% and 74.6% (p=0.76) of patients in the intervention and standard arm, respectively, indicated to not be sexually active. Sexual activity slightly increased over time to 38.5% in the intervention group vs 33.9% in the standard arm (p=0.47) at two years after randomisation. Most frequently given reasons for not being sexually active were either sex not being important or medical issues of their partner or themselves. No differences in sexual and vaginal problems were observed between treatment arms (p=0.83). All PORTEC-4a trial patients reported slightly higher sexual activity scores than an aged-matched normative population, figure 1C.

Conclusion Individualised treatment in the molecular arm of the PORTEC-4a trial led to a significant reduction in use of adjuvant treatment, with similar HRQL and sexual well-being.

Disclosures No disclosures.

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