NEW DELHI: Molecular profiling can safely reduce radiotherapy for women with early-stage endometrial cancer while identifying those who would benefit from more intensive treatment, according to a study that marks a significant step forward in personalised cancer treatment.
Endometrial cancer is a type of gynaecological cancer, most often affecting women after menopause.
For women with high-intermediate-risk disease, adjuvant radiotherapy -- particularly vaginal brachytherapy (a form of internal radiotherapy delivered directly to the vaginal area) -- is commonly used after surgery to reduce the risk of recurrence.
However, patients don't need it equally, and some may receive more treatment than necessary, exposing them to potential side effects without added benefit.
The study showed that molecular profiling -- a method that examines the genetic and biological features of a tumour can guide clinical decisions. It helps identify which patients are most likely to benefit from radiotherapy, and which can safely avoid it.
The team enrolled 592 women across eight European countries with (high-) intermediate-risk endometrial cancer.
The results, presented at the ongoing ESTRO 2025, the annual congress of the European Society for Radiotherapy and Oncology (ESTRO) in Vienna, Austria, highlights that molecular profiling helps tailor radiotherapy decisions based on individual tumour characteristics.
Nearly half of the patients in the trial safely avoided radiation without compromising cancer control.
"By using molecular profiling, we can tailor treatment to each patient's individual risk, " said Dr. Anne Sophie V.M. van den Heerik, lead investigator from The Leiden University Medical Center, The Netherlands.
"This approach allows us to safely reduce radiotherapy for many women while ensuring that those who need it receive the most effective therapy. It's a major step towards more personalized and less invasive cancer treatment, " Heerik said.
Further, patients with an unfavourable molecular profile received a more intensive radiation approach, pelvic radiotherapy, instead of vaginal brachytherapy. The results suggest better locoregional control, with a recurrence rate of 8.4 per cent compared to 30.5 per cent in those who received standard treatment without molecular profiling.
The findings demonstrate that nearly half of patients can be safely spared radiotherapy while maintaining excellent survival rates.