Objective: To evaluate recurrence and survival associated with adjuvant carboplatin and paclitaxel chemotherapy interposed with involved field radiation for advanced endometrial cancer.
Method: This is a prospective cohort study of women with Stage III and IV endometrial cancer treated at a single institution between April 2002 and July 2006. Adjuvant therapy consisted of 4 cycles of intravenous paclitaxel (175 mg/m(2)) and carboplatin (350 mg/m(2)) every 3 weeks, followed by external beam radiotherapy (RT) to the pelvis (45 Gy), then another 2 cycles of chemotherapy. Para-aortic RT and/or HDR vault brachytherapy were added at the discretion of the treating physician. Toxicity of this protocol was previously reported. Primary endpoints for this study were disease-free and overall survival rates.
Results: Forty-three patients with a median age of 64 years (46-83 years) were evaluated. The majority had Stage IIIC disease (63%), and the most common histology was serous carcinoma (49%). Six cycles of combination chemotherapy were completed in 81%, and all patients completed pelvic RT. Median follow-up was 30 months (9-71 months). Twenty-one patients (49%) recurred at a median of 17 months (7-62 months). There were only 3 local recurrences, including 2 in the pelvis and 1 in the vagina/vulva. Median disease-free survival (DFS) was 50 months and median overall survival (OS) has not been reached. Three year DFS and OS rates were 53% and 68%, respectively.
Conclusion: Adjuvant carboplatin and paclitaxel chemotherapy interposed with involved field radiation is associated with a low rate of local recurrence and favorable survival for advanced endometrial cancer.