Objective: The objective of this study was to evaluate the outcome and feasibility of concurrent chemotherapy with paclitaxel plus carboplatin and radiotherapy (RT) in patients with high-risk or advanced endometrial cancer.
Methods: A retrospective analysis of patients treated between January 2003 and December 2009 was conducted. Adjuvant therapy consisted of external beam radiation to the pelvis (45-48.6 Gy) and weekly administration of paclitaxel (40 mg/m(2)) plus carboplatin with an area under the curve of 2 administered intravenously during RT. Two further cycles of paclitaxel (175 mg/m(2)) and carboplatin (area under the curve, 5), separated by 4 weeks, were administered at the end of RT for advanced stage disease. Para-aortic RT and/or vault brachytherapy were added at the discretion of the physicians.
Results: A total of 31 patients with a median age of 56 years (31-69 years) were evaluated. The majority had stage III disease (58%), and the most common histology was endometrioid adenocarcinoma (78%). All patients completed the planned RT. The median follow-up time was 64 months (12-86 months). Five patients' conditions progressed, and all 5 died of the disease. Most of the 5 patients were with serous histologic type and advanced stage disease. There was no local recurrence. The 2-, 3-, and 5-year progression-free survival rates were 87%, 84%, and 79%, respectively. The 2-, 3-, and 5-year overall survival rates were 94%, 87%, and 83%, respectively. Toxicity included grade 3/4 neutropenia in 45.2% of patients, gastrointestinal toxicity in 32.3% of patients, and grade 1/2 sensory neuropathy in 38.7% of patients.
Conclusions: Concomitant paclitaxel plus carboplatin and radiation was feasible and well tolerated and resulted in excellent local-regional control. However, distant metastases continued to occur in more advanced-stage patients. This regimen appears reasonable to be tested for efficacy in randomized studies.