A pilot study of combination chemotherapy with paclitaxel, pirarubicin, and carboplatin (TPC) for endometrial carcinoma.
BACKGROUND
Although anthracyclines are considered as being among the most potent chemotherapeutic agents for endometrial carcinoma, the majority of institutions in Japan prefer a combination of paclitaxel and carboplatin (TC) for treating this disease. We retrospectively evaluated the efficacy and feasibility of combined paclitaxel, pirarubicin, and carboplatin (TPC) therapy for endometrial carcinoma.


METHODS
Thirty-nine patients with high/intermediate postoperative recurrence risks or with advanced disease received combination chemotherapy consisting of paclitaxel (150 mg/m(2)), pirarubicin (35 mg/m(2)), and carboplatin [area under the concentration time curve (AUC = 4)] from 2001 to 2006 at Okayama University Hospital. Treatment cycles were repeated every 3 weeks, and three to nine cycles were administered according to patient risk.


RESULTS
The 1-year overall survival (OS) and progression-free survival (PFS) rates were 94.9% and 84.6%, respectively, and the 3-year OS and PFS rate was 81.3%. Hematologic toxicities >grade 3 were: anemia 30.8%; leukopenia 84.6%; thrombocytopenia 20.5%. Neutropenia was common, and administration of granulocyte colony-stimulating factor (G-CSF) was necessary in 87.9% of treatment courses. Although grade 3 or 4 neutropenia was unavoidable, we could administer TPC therapy safely and without delay with G-CSF support. Gastrointestinal and neurological toxicity were less severe and less frequent compared with TC, and no cardiac toxicity was observed.


CONCLUSIONS
The 3-year PFS and OS rates even in high-risk patients were satisfactory, and we confirmed the feasibility of using this regimen for treating endometrial carcinoma.
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Kita-ku, Okayama, 700-8558, Japan. hongo1@cc.okayama-u.ac.jp
Atsushi
A
Hongo
Tomoyuki
T
Kusumoto
Keiichiro
K
Nakamura
Noriko
N
Seki
Junichi
J
Kodama
Yuji
Y
Hiramatsu
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007564:Japan; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D010865:Pilot Projects; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D004317:Doxorubicin; D016190:Carboplatin; C027260:pirarubicin; D017239:Paclitaxel