Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomized, phase 3 trial
March 1, 2018
Does adjuvant chemotherapy during and after radiotherapy versus pelvic radiotherapy alone improve survival for women with high-risk endometrial cancer?
EBRT (4860 cGy)
EBRT (4860 cGy) + Cisplatin 50 mg/m2 in wks 1 and 4
Carboplatin AUC 5 and Paclitaxel 175 mg/m2 q3wks x4 cycles
Co-primary: PFS and OS
Endometrioid histology: Stage IA Grade 3 with +LVSI , Stage IB Grade 3 , Stage II or III
Serous or Clear Cell: Stage IA (with invasion), Stage IB, II, III
Carcinosarcoma
bulky cervical involvement with radical hysterectomy
residual macroscopic disease
ChemoRT vs. RT:
median f/u: 60.2 mos
5yr OS: 81.8% vs.76.6% (NS)
5yr PFS: 75.5% vs. 68.6% (SS)
Stage III patients:
5 yr PFS: 69.3% vs 58.0% (SS)
5 yr OS: 78.7% vs. 69.8% (NS)
grade 3/4 Hematologic: 45% vs. 5% (SS)
grade 3/4 GI: 14% vs. 5% (SS)
grade 3/4 Neuropathy: 7% vs. 0% (SS)
At 12 months no significant difference in any grade 3 toxicity
Addition of chemotherapy to EBRT improves PFS, yet OS is unchanged, in women with high risk endometrial cancer. Effect most pronounced in stage III disease and women 70+.