Concomitant chemotherapy and radiation for the treatment of advanced-stage endometrial cancer.
BACKGROUND
Ccombination chemotherapy and radiation therapy is used for adjuvant treatment of stage III-IV endometrial cancer. The goal of this study was to review the treatment duration, toxicity, and survival for patients treated with concomitant chemotherapy and radiation.


METHODS
Women with stage III-IV endometrial cancer treated with concurrent chemotherapy and radiation between 2006 and 2013 were included. Toxicities were classified per CTCAE v3.0 and RTOG/EORTC late radiation morbidity scoring. Descriptive statistics were used to quantify treatment and toxicities. Kaplan-Meier method was used to estimate survival.


RESULTS
Fifty-one patients met our inclusion criteria. Median age was 60 (range 33-85). Thirty-six patients (70.6%) had endometrioid histology, 13 patients (25.5%) had serous, clear cell, or mixed histology, and 2 women (3.9%) had carcinosarcoma. Forty-eight patients had stage III disease and three patients were stage IVB. Mean treatment duration was 107 ± 19 days. Forty-two patients received all planned chemotherapy, and 16 patients required a dose reduction. Thirty-four patients (66.7%) experienced grade 3-4 toxicities, the majority of which were hematologic. There were no deaths related to therapy. Eighty-six percent of patients received leukocyte growth factors, and 25% of patients received a blood transfusion. Seven late grade 3-4 complications occurred: four gastrointestinal and two genitourinary, and one patient had ongoing neuropathy. Median progression-free survival was 42.8 months (range 4.4-81.5 months) and median overall survival was 44.9 months (range 5.1-82.6 months). Three-year overall survival was 80%.


CONCLUSIONS
Concomitant chemotherapy and radiation is an adequately tolerated treatment modality that allows for shorter treatment duration.
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA. Electronic address: ivywilkry@gmail.com.
I
I
Wilkinson-Ryan
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA.
P S
PS
Binder
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA.
S
S
Pourabolghasem
Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA.
N
N
Al-Hammadi
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA.
K
K
Fuh
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA.
A
A
Hagemann
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA.
P
P
Thaker
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA.
J
J
Schwarz
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA.
P
P
Grigsby
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA.
D
D
Mutch
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO, USA.
M
M
Powell
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D059186:Chemoradiotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies
D016190:Carboplatin; D017239:Paclitaxel; D007069:Ifosfamide
chemoradiation; chemotherapy and radiation; concomitant chemotherapy and radiation; concurrent; endometrial cancer