article = {ACO-2018-1-105}
title = {Impact of Greater than Three Cycles of Adjuvant Chemotherapy plus Vaginal Brachytherapy on Outcome of Patients with At-Risk Stage I-II Endometrial Carcinoma}
journal = {Annals of Clinical Oncology}
year = {2018}
issn = {2674-3248}
doi = {http://dx.doi.org/10.31487/j.ACO.2018.01.005}
url = {https://www.sciencerepository.org/impact-of-greater-than-three-cycles-of-adjuvant-chemotherapy-plus-vaginal-brachytherapy-on-outcome-of-patients_ACO-1-105 
author = { Haley K.  Perlow, Lorraine  Portelance,Aaron Wolfson,Benjamin  Rich,Brian Slomovitz,Joseph M. Pearson,Joyson  Kodiyan,M. Reis Isildinha ,}
keywords = {Endometrial cance, endometrial carcinoma,chemoradiotherapy ,brachytherapy}
abstract ={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}