Impact of Greater than Three Cycles of Adjuvant Chemotherapy plus Vaginal Brachytherapy on Outcome of Patients with At-Risk Stage I-II Endometrial Carcinoma

Impact of Greater than Three Cycles of Adjuvant Chemotherapy plus Vaginal Brachytherapy on Outcome of Patients with At-Risk Stage I-II Endometrial Carcinoma

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Benjamin Rich
Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine

A B S T R A C T

Objectives: A phase III clinical trial evaluating adjuvant vaginal brachytherapy (VBT) and three cycles of chemotherapy for patients with at-risk surgical stage I-II endometrial carcinoma did not find a survival advantage compared to standard pelvic external beam irradiation. We performed a retrospective review at our institution examining our management approach to this patient population. Methods: 54 patients with surgically resected at-risk stage I-II endometrial carcinomas were treated adjuvantly between 1/1/2000 and 12/31/2014. Their medical records were abstracted retrospectively for pathological, clinical and follow-up data. Patients were followed for a minimum of two years. Results: Median follow-up was 47.6 months. 22 patients underwent 0-3 cycles of adjuvant chemotherapy and VBT (Group 1), and 32 received > three (median: 6) cycles of chemotherapy with VBT (Group 2). Toxicity was similar between treatment cohorts [2/22 (9.1%) in Group 1 vs 2/32 (6.3%) in Group 2, p=1.0]. The estimated 5-year disease-free survival rate (DFS) was 84.3% for all 54 patients. Patients in Group 1 had an estimated 5-year DFS of 87.5% versus 81.3% for those in Group 2 (p=0.237). The estimated 5-year overall survival (OS) was 97.9% for all patients. Conclusion: In this retrospective study, there was no significant increase in patient toxicity or disease-free survival with more than three cycles of chemotherapy coupled with VBT for women with at-risk stage I/II endometrial carcinoma. A prospective clinical trial is recommended to further assess the efficacy of more than three cycles of chemotherapy and VBT as an adjuvant treatment option for this patient population

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Article Type
Research Article
Publication history
Received: Fri 04, Jan 2019
Accepted: Wed 16, Jan 2019
Published: Wed 30, Jan 2019
Copyright
© 2021 Benjamin Rich. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.ACO.2018.01.005