Adjuvant paclitaxel and carboplatin chemotherapy with involved field radiation in advanced endometrial cancer: A sequential approach

Journal Article · Mon Jan 01 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2006.08.006· OSTI ID:20850302

Lupe, Krystine ^[1]; Kwon, Janice ^[2]; D'Souza, David ^[1]; Gawlik, Christine ^[3]; Stitt, Larry ^[4]; Whiston, Frances ^[5]; Nascu, Patricia ^[6]; Wong, Eugene ^[1]; Carey, Mark S ^[2]

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1. Department of Radiation Oncology, University of Western Ontario and London Health Sciences Centre, London, Ontario (Canada)
2. Division of Gynecologic Oncology, University of Western Ontario and London Health Sciences Centre, London, Ontario (Canada)
3. Department of Pharmacy, University of Western Ontario and London Health Sciences Centre, London, Ontario (Canada)
4. Department of Biostatistics and Epidemiology, University of Western Ontario and London Health Sciences Centre, London, Ontario (Canada)
5. Clinical Cancer Research Program, University of Western Ontario and London Health Sciences Centre, London, Ontario (Canada)
6. Department of Obstetrics and Gynecology, University of Western Ontario and London Health Sciences Centre, London, Ontario (Canada)

Purpose: To determine the feasibility of adjuvant paclitaxel and carboplatin chemotherapy interposed with involved field radiotherapy for women with advanced endometrial cancer. Methods and Materials: This was a prospective cohort study of women with Stage III and IV endometrial cancer. Adjuvant therapy consisted of 4 cycles of paclitaxel (175 mg/m{sup 2}) and carboplatin (350 mg/m{sup 2}) every 3 weeks, followed sequentially by external beam radiotherapy (RT) to the pelvis (45 Gy), followed by an additional two cycles of chemotherapy. Para-aortic RT and/or HDR vault brachytherapy (BT) were added at the discretion of the treating physician. Results: Thirty-three patients (median age, 63 years) received treatment between April 2002 and June 2005. Median follow-up was 21 months. Stage distribution was as follows: IIIA (21%), IIIC (70%), IVB (9%). Combination chemotherapy was successfully administered to 30 patients (91%) and 25 patients (76%), before and after RT respectively. Nine patients (27%) experienced acute Grade 3 or 4 chemotherapy toxicities. All patients completed pelvic RT; 19 (58%) received standard 4-field RT and 14 (42%) received intensity-modulated radiotherapy. Ten (30%) received extended field radiation. Four patients (12%) experienced acute Grade 3 or 4 RT toxicities. Six (18%) patients developed chronic RT toxicity. There were no treatment-related deaths. Two-year disease-free and overall survival rates were both 55%. There was only one pelvic relapse (3%). Conclusions: Adjuvant treatment with combination chemotherapy interposed with involved field radiation in advanced endometrial cancer was well tolerated. This protocol may be suitable for further evaluation in a clinical trial.

• OSTI ID: 20850302
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 67; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
CHEMOTHERAPY
CLINICAL TRIALS
DEATH
EVALUATION
NEOPLASMS
PATIENTS
PELVIS
TOXICITY
WOMEN