Adjuvant chemotherapy with cisplatin, doxorubicin, and cyclophosphamide (PAC) for early-stage high-risk endometrial cancer: A preliminary analysis
| Autor: | David M. Gershenson, Thomas W. Burke, Creighton L. Edwards, C.A. Stringer, Alan N. Gordon, J.T. Wharton |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
Oncology
medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Cardiomyopathy Gastroenterology Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Prospective Studies Stage (cooking) Prospective cohort study Aged Cisplatin Chemotherapy business.industry Endometrial cancer Obstetrics and Gynecology General Medicine Middle Aged medicine.disease Combined Modality Therapy Surgery Radiation therapy Doxorubicin Uterine Neoplasms Female business medicine.drug |
| Zdroj: | Gynecologic Oncology. 38:305-308 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/0090-8258(90)90063-q |
| Popis: | Between October 1985 and January 1989, 33 patients with stage I (31) or clinically occult stage II (2) endometrial cancer at a high risk for recurrence were entered in a prospective study evaluating adjuvant cisplatin, doxorubicin, and cyclophosphamide (PAC) chemotherapy. Eligibility criteria included grade 2 tumors with middle- or outer-third myometrial invasion (16), grade 3 tumors with any degree of myometrial invasion (17), presence of extrauterine disease with no gross residual (17), or a high-risk histologic subtype including papillary serous (4), adenosquamous (5), or clear cell (1) tumors. Patients received PAC (50/50/500 mg/m 2 ) at 4-week intervals for six cycles. Thirty patients (90%) completed therapy. Toxicity included severe neutropenia in 14 patients, neutropenic sepsis in 2 patients, and doxorubicin-related cardiomyopathy in 1 patient. There were no treatment deaths. Current median follow-up is 25 months. Nine patients (27%) have developed a recurrence, 7 of whom died, after a median interval of 14 months. Eight of the 9 with recurrence initially had extrauterine disease ( P = 0.02). The resulting 2-year actuarial progression-free and overall survival rates were 79 and 83%, respectively. The median progression-free interval was 29 months for patients with extrauterine disease and 45 + months for those with no extrauterine disease ( P = 0.02). These results suggest that a phase 3 randomized trial comparing adjuvant PAC with radiation therapy is warranted. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|