Adjuvant Carboplatin and Paclitaxel Chemotherapy Followed by Radiotherapy in High-Risk Endometrial Cancer: A Retrospective Analysis
| Autor: | Guilherme Harada, Renata Colombo Bonadio, Vanessa da Costa Miranda, Samantha Cabral Severino da Costa, Daniela Reis Joaquim de Freitas, Elias Abdo Filho, Patrícia Alves Ferreira, F. Gabrielli, Maria Del Pilar Estevez Diz, Renata Gondim Meira Velame de Azevedo |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Paclitaxel medicine.medical_treatment lcsh:RC254-282 Carboplatin 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Original Reports medicine Humans Survival rate Survival analysis Aged Retrospective Studies Chemotherapy business.industry Endometrial cancer Cancer Middle Aged medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Antineoplastic Agents Phytogenic Endometrial Neoplasms Survival Rate Radiation therapy Serous fluid 030104 developmental biology chemistry 030220 oncology & carcinogenesis Female business |
| Zdroj: | Journal of Global Oncology, Vol 4, Pp 1-8 (2018) Journal of Global Oncology |
| ISSN: | 2378-9506 |
| Popis: | e17115 Background: It remains unclear which is the best chemotherapy (CT) regimen and what is the role of adding radiotherapy (RT) to adjuvant CT in high-risk endometrial cancer. Methods: We performed a retrospective analysis of the patients (pts) with high-risk endometrial cancer (endometrioid histology stages III-IVA or carcinossarcoma/ clear cells/ serous histology stages I-IVA) treated with adjuvant carboplatin (AUC 5) and paclitaxel (175 mg/m2), every 3 weeks, for 6 cycles, followed by RT (conformal external beam radiotherapy to pelvic or pelvic and paraortic fields with 45Gy-54Gy plus weekly vaginal brachytherapy with 20Gy in 4 fractions). Pts were treated from 2010 to 2016 at a Brazilian public cancer center. Medical records were reviewed for demographic, clinicopathologic and outcome information. Data was analyzed for overall survival (OS), disease-free survival (DFS), prognostic factors and toxicity. The Kaplan-Meier method was used for survival analysis and Cox proportional hazard model for prognostic factors. Results: 146 consecutive pts were evaluated. Median age was 62 years (range 35-81). Most patients had ECOG 0-1 (98%), endometrioid (53%) or serous histology (26%), grade 3 tumor (57%) and FIGO stage III (77%). Median follow-up was 26.5 months. The OS rates were 85% (95% CI 75 – 91%) in 3 years and 73% (95% CI 58 – 84%) in 5 years. Factors that significantly affected OS in a multivariate analysis were FIGO stage (p = .009), pelvic lymphadenectomy (yes vs no, p = .023) and positive peritoneal cytology (yes vs no, p = .002). 3-year and 5-year DFS rates were 79% (95% CI 70 – 86%) and 68% (95% CI 52 – 80%), respectively. The initial site of recurrence was limited to the pelvis in 3% of the pts, within the abdomen in 1% and extra-abdominal in 11%. Grade 3/4 AEs occurred in 47% of the pts and were mainly hematologic toxicity (43%). There were only 3 cases of febrile neutropenia and 4 cases of hospitalization due to toxicity. Conclusions: Our data suggests that adjuvant carboplatin and paclitaxel, followed by RT, in high-risk endometrial cancer is safe and effective. Low rates of pelvic recurrence were observed, which might be explained by the addition of RT to adjuvant CT. |
| Databáze: | OpenAIRE |
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