Concurrent carboplatin/paclitaxel and intravaginal radiation in surgical stage I–II serous endometrial cancer

Abstract

Objective To report a single institution experience in surgical stage I–II serous endometrial cancer using combined carboplatin/paclitaxel and intravaginal radiation (IVRT). Methods Between 10/00 and 12/06, 25 stage I–II patients with serous endometrial cancer were treated at our institution with surgery, postoperative IVRT, and concurrent chemotherapy (CT). Results The mean age was 67 years old (range, 53–80 years). Surgery consisted of hysterectomy (TAH/BSO, 64%, LAVH/BSO, 36%), peritoneal washing, omental biopsy, and pelvic lymph-node dissection (median 14 nodes). Para-aortic node sampling was done in 88% (median, 6). IVRT median dose was 21 Gy (range, 18–21 Gy, in 3 fractions) and concurrent CT consisted of carboplatin to AUC = 5 and taxol to 175 mg/m 2 given every 3 weeks for 6 cycles. CT was well tolerated with 22/25 (88%) receiving 6 cycles. Three patients received ≤ 5 cycles; 2 owing to physician preference (3 and 4 cycles) and 1 owing to toxicity (5 cycles). Only 1 patient (4%) had grade 3 toxicity (abscess). Grade 2 neurotoxicity was seen in 5 patients (20%). All patients finished their IVRT as scheduled, and there was no grade 3 toxicity. With a median follow-up of 30 months, the 5-year progression-free and overall survival rate was 88%. None of the patients developed vaginal recurrence. Conclusions Based on this study, surgical staging followed by IVRT and carboplatin/paclitaxel is well tolerated and effective in stage I–II serous endometrial cancer. Confirmation of these results on a larger number of patients with longer follow-up is still needed.