Concomitant chemotherapy and radiation for the treatment of advanced-stage endometrial cancer

Gynecol Oncol. 2014 Jul;134(1):24-8. doi: 10.1016/j.ygyno.2014.05.002. Epub 2014 May 10.

Abstract

Introduction: Ccombination chemotherapy and radiation therapy is used for adjuvant treatment of stage III-IV endometrial cancer. The goal of this study was to review the treatment duration, toxicity, and survival for patients treated with concomitant chemotherapy and radiation.

Methods: Women with stage III-IV endometrial cancer treated with concurrent chemotherapy and radiation between 2006 and 2013 were included. Toxicities were classified per CTCAE v3.0 and RTOG/EORTC late radiation morbidity scoring. Descriptive statistics were used to quantify treatment and toxicities. Kaplan-Meier method was used to estimate survival.

Results: Fifty-one patients met our inclusion criteria. Median age was 60 (range 33-85). Thirty-six patients (70.6%) had endometrioid histology, 13 patients (25.5%) had serous, clear cell, or mixed histology, and 2 women (3.9%) had carcinosarcoma. Forty-eight patients had stage III disease and three patients were stage IVB. Mean treatment duration was 107 ± 19 days. Forty-two patients received all planned chemotherapy, and 16 patients required a dose reduction. Thirty-four patients (66.7%) experienced grade 3-4 toxicities, the majority of which were hematologic. There were no deaths related to therapy. Eighty-six percent of patients received leukocyte growth factors, and 25% of patients received a blood transfusion. Seven late grade 3-4 complications occurred: four gastrointestinal and two genitourinary, and one patient had ongoing neuropathy. Median progression-free survival was 42.8 months (range 4.4-81.5 months) and median overall survival was 44.9 months (range 5.1-82.6 months). Three-year overall survival was 80%.

Conclusion: Concomitant chemotherapy and radiation is an adequately tolerated treatment modality that allows for shorter treatment duration.

Keywords: chemoradiation; chemotherapy and radiation; concomitant chemotherapy and radiation; concurrent; endometrial cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage
  • Chemoradiotherapy, Adjuvant
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / radiotherapy*
  • Female
  • Humans
  • Ifosfamide / administration & dosage
  • Middle Aged
  • Neoplasm Staging
  • Paclitaxel / administration & dosage
  • Radiotherapy, Intensity-Modulated
  • Retrospective Studies

Substances

  • Carboplatin
  • Paclitaxel
  • Ifosfamide