Five-year outcomes of adjuvant carboplatin/paclitaxel chemotherapy and intravaginal radiation for stage I-II papillary serous endometrial cancer Journal Article
| Authors: | Kiess, A. P.; Damast, S.; Makker, V.; Kollmeier, M. A.; Gardner, G. J.; Aghajanian, C.; Abu-Rustum, N. R.; Barakat, R. R.; Alektiar, K. M. |
| Article Title: | Five-year outcomes of adjuvant carboplatin/paclitaxel chemotherapy and intravaginal radiation for stage I-II papillary serous endometrial cancer |
| Abstract: | Objective: The purpose of this study is to report our single-institution experience with concurrent adjuvant intravaginal radiation (IVRT) and carboplatin/paclitaxel chemotherapy for early stage uterine papillary serous carcinoma (UPSC). Methods: From 10/2000 to 12/2009, 41 women with stage I-II UPSC underwent surgery followed by IVRT (median dose of 21 Gy in 3 fractions) and concurrent carboplatin (AUC = 5-6) and paclitaxel (175 mg/m 2) for six planned cycles. IVRT was administered on non-chemotherapy weeks. The Kaplan-Meier method was used to estimate survival, and the log-rank test was used for comparisons. Results: Median patient age was 67 years (51-80 years). Surgery included hysterectomy, bilateral salpingo-oophorectomy, peritoneal washings, omental biopsy, and pelvic and paraaortic lymph node sampling. FIGO 2009 stage was IA in 73%, IB in 10%, and II in 17%. Histology was pure serous in 71% of cases. Thirty-five patients (85%) completed all planned treatment. With a median follow-up time of 58 months, the 5-year disease-free (DFS) and overall survival (OS) rates were 85% (95%CI, 73-96%) and 90% (95%CI, 80-100%). The 5-year pelvic, para-aortic, and distant recurrence rates were 9%, 5%, and 10%, respectively. There were no vaginal recurrences. Of the 4 pelvic recurrences, 2 were isolated and were successfully salvaged. Patients with stage II disease had lower DFS (71% vs. 88%; p = 0.017) and OS (71% vs. 93%; p = 0.001) than patients with stage I disease. Conclusions: Concurrent adjuvant carboplatin/paclitaxel chemotherapy and IVRT provide excellent outcomes for early stage UPSC. Whether this regimen is superior to pelvic radiation will require confirmation from the ongoing randomized trial. © 2012 Elsevier Inc. |
| Keywords: | adult; cancer survival; clinical article; human tissue; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; retrospective studies; overall survival; fatigue; histopathology; neutropenia; cancer recurrence; cancer combination chemotherapy; treatment duration; treatment planning; antineoplastic agents; conference paper; paclitaxel; cancer radiotherapy; disease free survival; chemotherapy; cancer staging; follow up; follow-up studies; endometrium carcinoma; hysterectomy; endometrial neoplasms; neoplasm staging; endometrium cancer; carboplatin; infection; lung toxicity; multiple cycle treatment; nephrotoxicity; allergy; mucosa inflammation; neuropathy; antineoplastic combined chemotherapy protocols; ovariectomy; tinnitus; drug administration schedule; pruritus; rash; gastrointestinal toxicity; radiation dose fractionation; patient compliance; brachytherapy; cystadenocarcinoma, serous; papillary carcinoma; leg edema; hearing impairment; uterine cancer; uterus carcinoma; serous; salpingectomy; intravaginal radiation; cystadenocarcinoma, papillary; papillary serous; chemoradiotherapy, adjuvant; musculoskeletal toxicity; vaginal toxicity |
| Journal Title: | Gynecologic Oncology |
| Volume: | 127 |
| Issue: | 2 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2012-11-01 |
| Start Page: | 321 |
| End Page: | 325 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2012.07.112 |
| PROVIDER: | scopus |
| PUBMED: | 22850412 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 November 2012" - "CODEN: GYNOA" - "Source: Scopus" |
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270Gardner -
263Makker -
629Barakat -
333Alektiar -
888Abu-Rustum -
227Kollmeier -
9Kiess -
10
Damast -
607Aghajanian
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