Paclitaxel and concomitant radiotherapy in high-risk endometrial cancer patients: preliminary findings.
BACKGROUND
There is still much debate about the best adjuvant therapy after surgery for endometrial cancer (EC) and there are no current guidelines. Radiotherapy (RT) alone does not seem to improve overall survival. We investigated whether concomitant Paclitaxel (P) and RT gave better clinical results.


METHODS
Twenty-three patients with high-risk EC (stage IIB, IIIA, IIIC or IC G3 without lymphadenectomy or with aneuploid tumor) underwent primary surgery and were then referred for adjuvant therapy. P was given at a dose of 60 mg/m2 once weekly for five weeks during RT, which consisted of a total radiation dose of 50.4 Gy. Three further weekly cycles of P at a dose of 80 mg/m2 were given at the end of RT. Overall survival and disease-free survival were calculated from the time of surgery. Patterns of failure were recorded by the sites of failure.


RESULTS
A total of 157 cycles of P were administered both during radiotherapy and consolidation chemotherapy. Relapses occurred in five patients (21.7%). Median time to recurrence was 18.6 months (range 3-28). Survival rate for all the patients was 78.2%. Overall survival for the patients who completed chemo-radiation was of 81%. In this group median time to recurrence was 19.2 months (range 3-28). All recurrences were outside the radiation field. Mortality rate was 14.2%.


CONCLUSIONS
This small series demonstrates pelvic radiotherapy in combination with weakly P followed by three consolidation chemotherapy cycles as an effective combined approach in high risk endometrial carcinoma patients.
Mangili
Giorgia
G
Gynecology Department, San Raffaele Hospital, Milan, Italy. mangili.giorgia@hsr.it
De Marzi
Patrizia
P
Beatrice
Saverio
S
Rabaiotti
Emanuela
E
Viganò
Riccardo
R
Frigerio
Luigi
L
Gentile
Cinzia
C
Fazio
Ferruccio
F
D000368:Aged; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D011003:Ploidies; D011829:Radiation Dosage; D011838:Radiation-Sensitizing Agents / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D012307:Risk Factors; D017211:Treatment Failure
D011838:Radiation-Sensitizing Agents; D017239:Paclitaxel