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GOG 258

Adjuvant Chemotherapy plus Radiation for Locally Advanced Endometrial Cancer

Date of Publication:

June 13, 2019

Pubmed Link:
https://www.ncbi.nlm.nih.gov/pubmed/31189035
Hypothesis:

Is the addition of RT to chemotherapy superior to chemotherapy alone for women with advanced endometrial cancer?

Control Arm(s):

carboplatin AUC 6 + paclitaxel 175 mg/m2
q21 days for 6 cycles

Experimental Arm(s):

EBRT (4500cGy in 25 fractions at 180cGy per fraction) with cisplatin 50 mg/m2 days 1 and 29  
carboplatin AUC 5 or 6 + paclitaxel 175 mg/m2
q21 days for 4 cycles (with G-CSF)

Primary End Point:

PFS

Inclusion Criteria:

stage III or IVA endometrial carcinoma of any histologic subtype
stage I or II clear cell or serous endometrial carcinoma and positive peritoneal washings
LN optional

Exclusion Criteria:

Carcinosarcoma
Recurrent endometrial carcinoma
residual tumor >2cm

Results:

chemoRT vs chemo:
median f/u: 47 mos
5yr PFS: 59% vs 58% (NS)
No subgroup analysis demonstrated benefit from chemoradiotherapy
5yr vaginal cuff recurrence: 2% vs 7% (SS)
5yr pelvic or para-aortic recurrence: 11% vs 20% (SS)
5yr distance recurrence: 27% vs 21% (NS)
Grade 3+ adverse effects: 58% vs 63%

Conclusions:

Combined chemoRT did not provide a PFS benefit over chemotherapy alone in patients with advanced endometrial carcinoma.

Reviewer:
Courtney Griffiths, OTF