Chemotherapy for high-risk early-stage endometrial cancer.
OBJECTIVE
To discuss the usefulness of chemotherapy in high-risk early-stage endometrial cancer and the best chemotherapy regimen.


RESULTS
External radiation therapy has been successfully used to prevent local recurrence; however, it does not improve the overall survival and it increases the incidence of late toxicity. A recent randomized study revealed that adjuvant platinum-based combination chemotherapy might be a suitable alternative to radiotherapy for high-risk early-stage endometrial cancer. The optimal regimen is still in question because combinations of doxorubicin-cisplatin and paclitaxel-doxorubicin-cisplatin cause significant toxicity. The combination of paclitaxel-carboplatin may be better than doxorubicin-cisplatin with regard to toxicities.


CONCLUSIONS
Radiation treatment following surgery has been the standard adjuvant therapy for endometrial cancer for a long time. Radiotherapy decreases the local recurrence rates; however, a significant impact on the overall survival has not been demonstrated. The usefulness of adjuvant chemotherapy has been demonstrated by only a little evidence. Nonetheless, we are encouraged by a recent randomized study. In light of the excellent outcomes associated with early-stage endometrial cancer, it is important to conduct another large randomized trial based on standardization of high-risk criteria to evaluate the efficacy of adjuvant chemotherapy.
Kodama
Junichi
J
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Okayama, Japan. kodama@cc.okayama-u.ac.jp
Seki
Noriko
N
Hiramatsu
Yuji
Y
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016019:Survival Analysis