Paclitaxel and carboplatin sequenced with radiotherapy in women with advanced uterine serous carcinoma: Is this the optimal therapy?

Abstract

5084 Background: Uterine serous carcinoma (USC) often presents in advanced stages. The optimal post-operative therapy for women with USC has not been elucidated, as this histologic variant comprises a small proportion of the cases enrolled in clinical trials. Methods: A retrospective analysis of women diagnosed with USC from 1992–2002 was conducted. Data collected included demographics, stage at diagnosis, post-operative therapy, progression free survival (PFS), location of recurrence and overall survival (OS). Comparisons were performed using non-parametric ANOVA. Results: Between 1992–2002, there were 137 women diagnosed with USC, of whom 85 presented with either stage III or IV disease. Of these 85 women, 11 refused post-operative therapy, 12 underwent 6 cycles of paclitaxel (175 mg/m2) and carboplatin (AUC 6), 14 underwent whole abdominal radiotherapy (WAR), 9 had sequential therapy and the remaining 39 were treated with a variety of regimens. Sequential therapy consisted of paclitaxel and carboplatin at the above doses for 3 cycles, followed by volume-directed pelvic +/- para-aortic radiotherapy and an additional 3 cycles of chemotherapy. There was no significant difference between the groups with regards to age or stage of disease. Data regarding PFS and OS is presented in the table below. Median follow-up for the 46 women included in the analysis is 17.5 months. Only 1 woman treated with sequential therapy experienced a recurrence (21 months) with a median follow-up in this group of 38 months. Conclusions: Sequential chemotherapy and radiotherapy extends progression free and overall survival in women with advanced stage USC. Further investigation using combined modality therapy in women with advanced endometrial carcinoma is being conducted by the GOG, however efforts should focus on enrolling women with USC in protocols using multimodality therapy. No significant financial relationships to disclose.