Adjuvant Chemotherapy plus Radiation for Locally Advanced Endometrial Cancer
June 13, 2019
Is the addition of RT to chemotherapy superior to chemotherapy alone for women with advanced endometrial cancer?
carboplatin AUC 6 + paclitaxel 175 mg/m2
q21 days for 6 cycles
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)
PFS
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
Carcinosarcoma
Recurrent endometrial carcinoma
residual tumor >2cm
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%
Combined chemoRT did not provide a PFS benefit over chemotherapy alone in patients with advanced endometrial carcinoma.