Adjuvant Pelvic Radiotherapy vs.Sequential Chemoradiotherapy for High-Risk StageⅠ-ⅡEndometrial Carcinoma

Objective To explore if the addition of adjuvant chemotherapy with paclitaxel and carboplatin to radiotherapy confers an advantage for overall survival(OAS),and progression free survival(PFS);to assess the incidence of relapses over standard pelvic radiotherapy; and to evaluate the related toxicity in high-risk stageⅠ-Ⅱendometrial carcinoma Methods Medical records were reviewed to identify high-risk stageⅠ-Ⅱendometrial carcinoma cases treated in the Clinical Oncology and Nuclear Medicine department between 2002 and 2008 with adjuvant radiotherapy alone(armⅠ)(57 patients) or with sequential carboplatin(AUC5-6) and paclitaxel(135-175 mg/m^2) with radiotherapy(armⅡ)(51 patients).Radiotherapy was performed through the four-field box technique at doses of 45-50 Gy(1.8 Gy/day×5 days/week). Results The toxicity was manageable and predominantly hematologic with a grade 3 neutropenia and thrombocytopenia in 9.8% and 6% of the patients in armⅠand armⅡ,respectively,without febrile neutropenia.All patients experienced hair loss. Chemoradiotherapy arm was associated with a lower incidence rate of relapse(9.8% vs.22.7% ).After a median follow-up period of 48 months,the 5-year OAS and PFS rates for chemoradiotherapy-treated patients were significantly more favorable than those who did not receive chemotherapy(P=0.02 and 0.03,respectively).In armⅠ,the OAS and PFS rates were 73.7% and 66.7% compared with those in armⅡ,whose rates were 90.2% and 84.3% . Conclusions Adjuvant chemoradiation with paclitaxel and carboplatin improved the survival rates and decreased the recurrence rates in patients with high-risk stageⅠ-Ⅱendometrial carcinoma.Chemotherapy was associated with an acceptable rate of toxicity. However,a prospective study with a larger number of patients is needed to define a standard adjuvant treatment for high-risk stageⅠ-Ⅱendometrial carcinoma.

Objective To explore if the addition of adjuvant chemotherapy with paclitaxel and carboplatin to radiotherapy confers an advantage for overall survival （OAS）, and progression free survival （PFS）; to assess the incidence of relapses over standard pelvic radiotherapy; and to evaluate the related toxicity in high-risk stage I-II endometrial carcinoma Methods Medical records were reviewed to identify high-risk stage I-1I endometrial carcinoma cases treated in the Clinical Oncology and Nuclear Medicine department between 2002 and 2008 with adjuvant radiotherapy alone （arm Ⅰ）（57 patients） or with sequential carboplatin （AUCS-6） and paclitaxel （135-175 mg/m^2） with radiotherapy （arm Ⅱ） （51 patients）. Radiotherapy was performed through the four-field box technique at doses of 45-50 Gy （1.8 Gy/day × 5 days/week）. Results The toxicity was manageable and predominantly hematologic with a grade 3 neutropenia and thrombocytopenia in 9.8% and 6% of the patients in arm Ⅰ and arm Ⅱ, respectively, without febrile neutropenia. All patients experienced hair loss. Chernoradiotherapy arm was associated with a lower incidence rate of relapse （9.8% vs. 22.7%）. After a median follow-up period of 48 months, the 5-year OAS and PFS rates for chemoradiotherapy-treated patients were significantly more favorable than those who did not receive chemotherapy （P=0.02 and 0.03, respectively）. In arm I, the OAS and PFS rates were 73.7% and 66.7% compared with those in arm II, whose rates were 90.2% and 84.3%. Conclusions Adjuvant chemoradiation with paclitaxel and carboplatin improved the survival rates and decreased the recurrence rates in patients with high-risk stage Ⅰ-Ⅱ endometrial carcinoma. Chemotherapy was associated with an acceptable rate of toxicity. However, a prospective study with a larger number of patients is needed to define a standard adjuvant treatment for high-risk stage Ⅰ-Ⅱ endometrial carcinoma.