Concurrent carboplatin/paclitaxel and intravaginal radiation in surgical stage I-II serous endometrial cancer.
OBJECTIVE
To report a single institution experience in surgical stage I-II serous endometrial cancer using combined carboplatin/paclitaxel and intravaginal radiation (IVRT).


METHODS
Between 10/00 and 12/06, 25 stage I-II patients with serous endometrial cancer were treated at our institution with surgery, postoperative IVRT, and concurrent chemotherapy (CT).


RESULTS
The mean age was 67 years old (range, 53-80 years). Surgery consisted of hysterectomy (TAH/BSO, 64%, LAVH/BSO, 36%), peritoneal washing, omental biopsy, and pelvic lymph-node dissection (median 14 nodes). Para-aortic node sampling was done in 88% (median, 6). IVRT median dose was 21 Gy (range, 18-21 Gy, in 3 fractions) and concurrent CT consisted of carboplatin to AUC=5 and taxol to 175 mg/m(2) given every 3 weeks for 6 cycles. CT was well tolerated with 22/25 (88%) receiving 6 cycles. Three patients received <or=5 cycles; 2 owing to physician preference (3 and 4 cycles) and 1 owing to toxicity (5 cycles). Only 1 patient (4%) had grade 3 toxicity (abscess). Grade 2 neurotoxicity was seen in 5 patients (20%). All patients finished their IVRT as scheduled, and there was no grade 3 toxicity. With a median follow-up of 30 months, the 5-year progression-free and overall survival rate was 88%. None of the patients developed vaginal recurrence.


CONCLUSIONS
Based on this study, surgical staging followed by IVRT and carboplatin/paclitaxel is well tolerated and effective in stage I-II serous endometrial cancer. Confirmation of these results on a larger number of patients with longer follow-up is still needed.
Alektiar
Kaled M
KM
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. gynbreast@mskcc.org
Makker
Vicky
V
Abu-Rustum
Nadeem R
NR
Soslow
Robert A
RA
Chi
Dennis S
DS
Barakat
Richard R
RR
Aghajanian
Carol A
CA
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D010052:Ovariectomy; D017239:Paclitaxel / Q000008:administration & dosage; D011878:Radiotherapy / Q000379:methods; D014621:Vagina
D016190:Carboplatin; D017239:Paclitaxel