Abstract:
Purpose: To study the efficacy and toxicity of adjuvant radiotherapy concomitant with cisplatin followed by paclitaxel, carboplatin in high risk early stage endometrial cancer.
Patient and methods: Patients with higher risk endometrial cancer defined in this study as those having > 50% myometrial invasion or grade 3 or lymphovascular invasion positive or those stage II, IIIA, or finally those with clear cell or papillary serous histology whatever the stage were enrolled post total abdominal hysterectomy and bilateral salpingo-oophorectomy with or without lymphadenectomy. Patients received adjuvant pelvic external beam (RTH) (46.8-50.4 Gy) concomitant with cisplatin (50 mg/m2) every 21 days followed by 4 cycles of paclitaxel 175 mg/m2 carboplatin (AUC5) every 21 days. Primary end point was disease free survival and the secondary end point were tolerability and toxicity.
Results
21 patients from clinical Oncology Department, Ain Shams University from June 2013-March 2016 were enrolled. The median follow up time was 21 months (range from 9—33 months). 19 patients (90.41%) completed the RTH and the 4 cycles of adjuvant CTH. Overall grade 3-4 hematological toxicity was 23.8%, it was mainly neutropenia. Grade 3-4 non hematological toxicity was seen in 3 patients (14.28%), 2 patients had grade 3 neuropathy and a third patient experienced grade 3 diarrhea with the chemotherapy. Disease recurrence was registered in 3/21 patients (14.28%). The
1 and 2 years DFS were 93.8% and 73.8% respectively.
Conclusion:
Adjuvant sequential RTH followed by paclitaxel, carboplatin is well tolerated and feasible regimen in patients with higher risk EC.