Postoperative external beam radiation therapy and concurrent cisplatin followed by carboplatin/paclitaxel for stage III (FIGO 2009) endometrial cancer Journal Article
| Authors: | Milgrom, S. A.; Kollmeier, M. A.; Abu-Rustum, N. R.; Tew, W. P.; Sonoda, Y.; Barakat, R. R.; Alektiar, K. M. |
| Article Title: | Postoperative external beam radiation therapy and concurrent cisplatin followed by carboplatin/paclitaxel for stage III (FIGO 2009) endometrial cancer |
| Abstract: | Objective The optimal adjuvant therapy in advanced endometrial cancer is controversial. One regimen is concurrent external beam pelvic irradiation (RT) and cisplatin, then carboplatin/paclitaxel. This study reports an institutional experience using this approach in stage III (FIGO 2009) endometrial cancer. Methods Patients with stage III (FIGO 2009) endometrial cancer who underwent total hysterectomy and bilateral salpingo-oophorectomy at a single institution from 01/2004 to 12/2009 were identified retrospectively. Those treated with adjuvant RT/cisplatin, followed by carboplatin/paclitaxel comprised the study population. Results Of the 40 eligible patients, 7 (18%) were stage IIIA and 33 (82%) IIIC. Nineteen patients (48%) were ≥ 60 years of age. Twenty-three (58%) had ≥ 50% myometrial invasion, 30 (75%) lymphovascular invasion, 11 (28%) cervical stromal invasion, and 5 (12%) positive peritoneal cytology. Histology was endometrioid in 32 (80%), serous in 6 (15%), and clear cell in 2 (5%). At a median follow-up of 49 months, the 5-year freedom from relapse was 79% and overall survival 85%. The 5-year rate of vaginal recurrence was 3%, non-vaginal pelvic recurrence 3%, para-aortic recurrence 11%, peritoneal recurrence 5%, and other distant recurrence 11%. Thirty-one patients (78%) were able to complete the planned RT/cisplatin and 4 cycles of carboplatin/ paclitaxel. Acute grade 3 toxicity occurred in 10 patients (4 neutropenia, 2 anemia, 1 fatigue, 2 diarrhea). No late toxicity was grade ≥ 3. Conclusion These favorable outcomes corroborate those of RTOG 9708. Until prospective data that compare adjuvant therapy regimens mature, concurrent chemoradiation should be strongly considered in stage III endometrial cancer. © 2013 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; clinical article; treatment outcome; aged; disease-free survival; middle aged; cancer surgery; survival rate; retrospective studies; overall survival; fatigue; histopathology; neutropenia; cancer recurrence; cisplatin; diarrhea; drug safety; side effect; paclitaxel; adjuvant therapy; cancer radiotherapy; postoperative care; chemotherapy, adjuvant; chemotherapy; cancer staging; follow up; endometrial cancer; endometrium carcinoma; hysterectomy; endometrial neoplasms; lymphatic metastasis; neoplasm staging; salpingooophorectomy; adenocarcinoma; cytology; carboplatin; multiple cycle treatment; anemia; radiation; antineoplastic combined chemotherapy protocols; peripheral neuropathy; tinnitus; vaginal dryness; radiotherapy, intensity-modulated; patient compliance; nausea and vomiting; external beam radiotherapy; intestine obstruction; cystitis; chemoradiation; leg edema; neuralgia; tumor invasion; proctitis; pelvic disease; lymph vessel metastasis; chemoradiotherapy, adjuvant; pelvic insufficiency fracture |
| Journal Title: | Gynecologic Oncology |
| Volume: | 130 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-09-01 |
| Start Page: | 436 |
| End Page: | 440 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2013.06.024 |
| PROVIDER: | scopus |
| PUBMED: | 23800696 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2013" - "CODEN: GYNOA" - "Source: Scopus" |
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