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256712

Concurrent Chemoradiation versus Radiotherapy Alone in Adjuvant Setting for High-Risk Endometrial Carcinoma

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Last updated: 22 Jan 2023

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Abstract

Background: For endometrial carcinoma, the main surgical treatment is total hysterectomy and bilateral salpingo-oophorectomy. Women with high-risk endometrial cancer have a relatively higher recurrence rates and poor prognosis following hysterectomy alone. Therefore, pelvic external beam radiotherapy has been the standard adjuvant treatment for these patients. This is a prospective study on patients with high-risk endometrial cancer evaluating the benefit of adding concurrent weekly paclitaxel with adjuvant radiotherapy, versus radiotherapy alone.
Methods: Eligible patients were randomized to Arm A; Concurrent chemotherapy with radiotherapy [CCRT], and Arm B; External beam pelvic radiotherapy alone [RTH]. Pelvic radiotherapy was 50.4Gy over 28 fractions, and chemotherapy course was weekly paclitaxel (50mg/m2) for 5 weeks. Patients were evaluated for treatment related toxicities, disease failures and survival.
Results: Seventy-one patients met the eligibility criteria of study protocol; 34 patients received CCRT; and 37 patients received RTH alone. The median age at time of diagnosis is 66 years. Regarding to tumor staging; 47% were Stage Ib, and other patients were stage II or III. Grade 3 toxicity were more in CCRT arm, and no grade 4 toxicity were recorded. The most common events were diarrhea and hematological affection. No significant difference in acute toxicities between treatment groups; except for hematological affection with concurrent paclitaxel [p=0.025]. Ten patients [14%] had a treatment failure; treatment failures are more in RTH group, but without statistical significance [p-value =0.51]. Estimated 2-years OS was around 86% with no statistical significance between both treatment arms [p-value = 0.83], and estimated 2-years DFS was; 83.2% for CCRT arm and 77.1% for RTH arm, with no statistical significance [p-value = 0.48].
Conclusion: Adding concurrent paclitaxel to pelvic radiotherapy in high-risk endometrial cancer patient is safe and tolerable, and tends to decrease treatment failures, even though this not translated to OS nor DFS improvement.

Keywords

Endometrial carcinoma, Radiotherapy, Concurrent Chemotherapy

Volume

10

Article Issue

3

Related Issue

35731

Issue Date

2022-07-01

Receive Date

2022-06-12

Publish Date

2022-06-21

Page Start

170

Page End

175

Print ISSN

2537-0995

Online ISSN

2314-8500

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https://secioj.journals.ekb.eg/article_256712.html

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https://secioj.journals.ekb.eg/service?article_code=256712

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256,712

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Publication Title

SECI Oncology Journal

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https://secioj.journals.ekb.eg/

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Article

Created At

22 Jan 2023