Abstract
BackgroundThere is still much debate about the best adjuvant therapy after surgery for endometrial cancer (EC) and there are no current guidelines. Radiotherapy (RT) alone does not seem to improve overall survival. We investigated whether concomitant Paclitaxel (P) and RT gave better clinical results.MethodsTwenty-three patients with high-risk EC (stage IIB, IIIA, IIIC or IC G3 without lymphadenectomy or with aneuploid tumor) underwent primary surgery and were then referred for adjuvant therapy. P was given at a dose of 60 mg/m2 once weekly for five weeks during RT, which consisted of a total radiation dose of 50.4 Gy. Three further weekly cycles of P at a dose of 80 mg/m2 were given at the end of RT. Overall survival and disease-free survival were calculated from the time of surgery. Patterns of failure were recorded by the sites of failure.ResultsA total of 157 cycles of P were administered both during radiotherapy and consolidation chemotherapy.Relapses occurred in five patients (21.7%). Median time to recurrence was 18.6 months (range 3–28). Survival rate for all the patients was 78.2%. Overall survival for the patients who completed chemo-radiation was of 81%. In this group median time to recurrence was 19.2 months (range 3–28). All recurrences were outside the radiation field. Mortality rate was 14.2%.ConclusionThis small series demonstrates pelvic radiotherapy in combination with weakly P followed by three consolidation chemotherapy cycles as an effective combined approach in high risk endometrial carcinoma patients.
Highlights
There is still much debate about the best adjuvant therapy after surgery for endometrial cancer (EC) and there are no current guidelines
EC patients often receive adjuvant radiation therapy to reduce the risk of pelvic relapse [6,7] but this does not seem to improve overall survival because it cannot reduce the risk of distant recurrences
Secondary we studied survival rates in the patients who completed at least five cycles of chemotherapy and all the RT in assessing the efficacy of this treatment
Summary
There is still much debate about the best adjuvant therapy after surgery for endometrial cancer (EC) and there are no current guidelines. Radiotherapy (RT) alone does not seem to improve overall survival. Patients with endometrial cancer (EC) are traditionally divided into risk categories, conventionally based on anatomical-surgical prognostic factors. There is much debate about the best adjuvant therapy after surgery and there are no accepted guidelines for this treatment. EC patients often receive adjuvant radiation therapy to reduce the risk of pelvic relapse [6,7] but this does not seem to improve overall survival because it cannot reduce the risk of distant recurrences. A new combined adjuvant treatment is needed to improve results in highrisk EC patients
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