Five-year outcomes of adjuvant carboplatin/paclitaxel chemotherapy and intravaginal radiation for stage I-II papillary serous endometrial cancer

Ana P. Kiess, Shari Damast, Vicky Makker, Marisa A. Kollmeier, Ginger J. Gardner, Carol Aghajanian, Nadeem R. Abu-Rustum, Richard R. Barakat, Kaled M. Alektiar

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Objective: The purpose of this study is to report our single-institution experience with concurrent adjuvant intravaginal radiation (IVRT) and carboplatin/paclitaxel chemotherapy for early stage uterine papillary serous carcinoma (UPSC). Methods: From 10/2000 to 12/2009, 41 women with stage I-II UPSC underwent surgery followed by IVRT (median dose of 21 Gy in 3 fractions) and concurrent carboplatin (AUC = 5-6) and paclitaxel (175 mg/m2) for six planned cycles. IVRT was administered on non-chemotherapy weeks. The Kaplan-Meier method was used to estimate survival, and the log-rank test was used for comparisons. Results: Median patient age was 67 years (51-80 years). Surgery included hysterectomy, bilateral salpingo-oophorectomy, peritoneal washings, omental biopsy, and pelvic and paraaortic lymph node sampling. FIGO 2009 stage was IA in 73%, IB in 10%, and II in 17%. Histology was pure serous in 71% of cases. Thirty-five patients (85%) completed all planned treatment. With a median follow-up time of 58 months, the 5-year disease-free (DFS) and overall survival (OS) rates were 85% (95%CI, 73-96%) and 90% (95%CI, 80-100%). The 5-year pelvic, para-aortic, and distant recurrence rates were 9%, 5%, and 10%, respectively. There were no vaginal recurrences. Of the 4 pelvic recurrences, 2 were isolated and were successfully salvaged. Patients with stage II disease had lower DFS (71% vs. 88%; p = 0.017) and OS (71% vs. 93%; p = 0.001) than patients with stage I disease. Conclusions: Concurrent adjuvant carboplatin/paclitaxel chemotherapy and IVRT provide excellent outcomes for early stage UPSC. Whether this regimen is superior to pelvic radiation will require confirmation from the ongoing randomized trial.

Original languageEnglish (US)
Pages (from-to)321-325
Number of pages5
JournalGynecologic oncology
Volume127
Issue number2
DOIs
StatePublished - Nov 2012
Externally publishedYes

Keywords

  • Brachytherapy
  • Chemotherapy
  • Intravaginal radiation
  • Papillary serous
  • Serous
  • Uterine cancer

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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