Toxicity, health-related quality of life and sexuality after molecular profile-based adjuvant treatment in high-intermediate risk endometrial cancer, PORTEC-4a
Year: 2026
Type: article
Abstract: PORTEC-4a was the first to incorporate molecular-integrated profile-guided adjuvant treatment in early-stage high-intermediate-risk endometrial cancer (EC), demonstrating non-inferiority. Here, adverse events (AE), health-related quality of life (HRQoL) and sexual health are reported. 564 patients were randomised to molecular-based adjuvant treatment ( n = 367) or standard vaginal brachytherapy (VBT, n = 197). In the molecular-profile arm, patients underwent observation, VBT or pelvic radiotherapy according to molecular-integrated profile. HRQoL and sexual functioning were assessed with EORTC QLQ-C30 and EN24 modules and compared with age-matched normative data. Median follow-up was 58.1 months; 523 (92.7%) patients were evaluable. Grade 1–2 AEs were less frequent in the molecular-profile arm at treatment completion compared with the standard arm (28.3% vs. 45.2%, p < 0.01), without differences in grade 3–4 AEs ( p = 0.46). Throughout follow-up, treatment-related grade 3–4 AEs were rare (1% vs. 2%). HRQoL remained comparable to normative data over time. Sexual interest/activity was similar between arms, but lower than normative values. 75.5% of patients reported ≥1 reason for sexual inactivity; disease-related sexual inactivity decreased from 24.2% to 9.2% at 3 years. Molecular-guided adjuvant treatment for patients with high-intermediate riskEC is associated with low toxicity, preserved HRQoL and slightly reduced sexual activity due to personal factors (no partner, sex not important in their relationship or partner-related medical issues) rather than their own illness.
Source: British Journal of Cancer
Authors: Anne Sophie V. M. Van den Heerik, Cathalijne C. B. Post, Marie A. D. Haverkort, Nienke Kuijsters, Stefan Kommoss, Friederike L. A. Koppe, Marlies E. Nowee, Henrike Westerveld, Maria A. A. De Jong, Filip Frühauf, Jeltsje S. Cnossen, Jan Willem M. Mens, Jannet C. Beukema, Cyrus Chargari, Charles Gillham, Dorine S. J. Tseng, Katrien Vandecasteele, Karen Verhoeven-Adema, Hans W. Nijman, Remi A. Nout, Bastiaan G. Wortman, Stephanie M. De Boer, Hein Putter, Vincent T. H. B. M Smit, Carien L. Creutzberg, Nanda Horeweg
Institutions: Leiden University Medical Center, Radiotherapiegroep, University Children's Hospital Tübingen, Instituut Verbeeten, The Netherlands Cancer Institute, Erasmus MC, Erasmus MC Cancer Institute, Amsterdam University Medical Centers, University of Amsterdam, Radiotherapeutisch Instituut Friesland, Charles University, General University Hospital in Prague, Catharina Ziekenhuis, University Medical Center Groningen, Institut Gustave Roussy, Cancer Trials Ireland, St. Luke's Hospital, University Medical Center Utrecht, Ghent University Hospital, Netherlands Comprehensive Cancer Organisation
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,190
OpenAlex ID: W7225773381