Sequential chemotherapy-radiotherapy as adjuvant treatment of high-risk endometrial carcinoma: a retrospective review of the Manchester experience
AuthorsMahmood, Reem D
Morgan, Robert David
Mitchell, Claire L
Barraclough, Lisa H
Livsey, Jacqueline E
Crosbie, E. J.
Edmondson, R. J.
Jayson, Gordon C
Clamp, Andrew R
AffiliationDepartment of Medical Oncology, Christie NHS Foundation Trust, M20 4BX Manchester
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AbstractObjective: The optimum sequencing of adjuvant treatment in patients with high-risk endometrial cancer remains contentious. Here, we report the outcomes of women treated in Manchester, United Kingdom, where sequential chemotherapy-radiotherapy is the standard adjuvant treatment approach for these patients. Methods: A retrospective analysis was carried out on 106 consecutive patients referred for adjuvant treatment of high-risk endometrial cancer in 2014 and 2015. High-risk endometrial cancer was defined as: International Federation of Gynaecology and Obstetrics (2009) stage I grade 3 endometrioid carcinoma with deep myometrial invasion and/or lymphovascular space invasion, stage II–III endometrioid carcinoma, or any other histological subtype with stage I–III disease. Adjuvant treatment included carboplatin (AUC5) and paclitaxel (175 mg/m2) every 21 days for 4/6 cycles, followed by external beam pelvic radiotherapy (40 Gy in 20 fractions#) or vaginal brachytherapy (28 Gy in 2 fractions#) or both. Primary outcome measures were recurrence free survival (RFS), overall survival (OS) and treatment-related toxicity. Results: Seventy-nine percent of patients were treated with sequential chemotherapy-radiotherapy. After a median follow-up of 64.4 months, 5-year RFS was 70% (95% CI 60.8–80.6%) and 5-year OS was 71.4% (95% CI 62.3–81.7%). Single modality adjuvant therapy was given for patient choice or contra-indications to treatment. Patients tolerated sequential treatment well; 96% of patients completed all treatment and 20% of patients had ≥grade 3 adverse events. Conclusions: Sequential chemotherapy-radiotherapy as adjuvant treatment for high-risk endometrial cancer was tolerable and was associated with survival outcomes consistent with recent international phase III clinical trials.
CitationMahmood RD, Morgan RD, Descamps T, Mitchell C, Hasan J, Mescallado N, et al. Sequential chemotherapy-radiotherapy as adjuvant treatment of high-risk endometrial carcinoma: a retrospective review of the Manchester experience. European Journal of Gynaecological Oncology. 2021;42(4):673.
JournalEuropean Journal of Gynaecological Oncology