Abstract
Background: As there are no current definite guidelines, there is still much debate about the best adjuvant therapy after surgery for endometrial cancer (EC). Radiotherapy (RT) alone does not seem to improve overall survival. We investigated whether concomitant Cisplatin (C) and RT gave better clinical results. Patients and methods: Ninety four patients with high-risk EC (stage II, IIIA or IB G3 without lymphadenectomy) underwent primary surgery and were then referred for adjuvant therapy. Cisplatin was given at a dose of 40 mg/m2 once weekly for five weeks during RT, which consisted of a total radiation dose of 50.4 Gy. Two cycles of cisplatin 75 mg/m2 and paclitaxel 175 mg/m2 were given after finishing the radiotherapy. Overall survival and disease-free survival were calculated from the time of surgery. Patterns of failure were recorded by the sites of failure. Results: Median overall Survival was 36 months. Median time to recurrence was 26 months (range 3-37). Relapses occurred in twenty nine patients (30.8%). Adverse events were mild with three cases having grade 3 neutropenia. Local recurrence was encountered in 14% and distant metastases in 8%. Conclusion: This phase II study demonstrates pelvic radiotherapy in combination with weekly cisplatin followed by two cycles of consolidation chemotherapy as a tolerable and efficient combined approach in high risk endometrial carcinoma patients.
Highlights
Cancer of the endometrium is the most common gynecologic malignancy and accounts for 6% of all cancers in women
This phase II study demonstrates pelvic radiotherapy in combination with weekly cisplatin followed by two cycles of consolidation chemotherapy as a tolerable and efficient combined approach in high risk endometrial carcinoma patients
Secondary we studied survival rates in the patients who completed all the radiochemotherapy in assessing the efficacy of this treatment
Summary
Cancer of the endometrium is the most common gynecologic malignancy and accounts for 6% of all cancers in women. It is a highly curable tumor [1]. Patients with endometrial cancer (EC) are traditionally divided into risk categories, conventionally based on anatomical-surgical prognostic factors. The most significant prognostic factors are stage, histologic type, depth of myometrial invasion, grade of differentiation and lymph-node metastases [2]. DNA content analysis can be useful to assess the risk of recurrence more precisely and ploidy appears to be one of the most important prognostic factors in EC [4]. For patients without extrauterine spread, the greatest determinants of recurrence were grade III histology, deep myometrial invasion. We investigated whether concomitant Cisplatin (C) and RT gave better clinical results
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