Adjuvant carboplatin and paclitaxel chemotherapy interposed with involved field radiation for advanced endometrial cancer

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. (C) 2009 Elsevier Inc. All rights reserved.