title: Chemotherapy for advanced endometrial cancer with carboplatin and epirubicin.
abstract: Endometrial cancer is the most common gynecological cancer in the Western world. In early-stage disease, surgery remains the mainstay of treatment. Adjuvant pelvic radiotherapy reduces the risk of pelvic recurrence, however, without improvement in overall survival. The aim of the present study was to assess the efficacy and toxicity of carboplatin and epirubicin combination chemotherapy for patients with advanced and high-risk endometrial cancer.
  
  
  METHODS
  Between 1999 and 2007, 43 patients with endometrial cancer were treated with carboplatin and epirubicin. Two groups were identified: Group 1 (n=34) included patients with stage III endometrial cancer receiving adjuvant chemotherapy; and group 2 included those with metastatic endometrial cancer (n=9).
  
  
  RESULTS
  After a median follow-up of 37 months, disease in 19 patients had progressed/relapsed (12 patients from group 1; 7 from group 2) and 23 patients had died (15 from group 1; 8 from group 2). The median time-to-progression was 62 months and median overall survival was 64 months. The median survival for patients in group 1 was 69 months and for those in group 2 was 22 months. Ten patients (27.9%) experienced grade 3 or 4 toxicities. There were no cases of treatment-related cardiac failure or neuropathy.
  
  
  CONCLUSIONS
  Cisplatin, carboplatin, anthracyclines and taxanes are the most active agents in endometrial cancer. Combination chemotherapy leads to better progression-free survival and overall survival, however, this is at the expense of increased toxicity. RESULTS from our study show that the combination of carboplatin and epirubicin is an effective alternative regimen for patients with advanced endometrial cancer. In addition, treatment-related toxicity is minimal when compared to anthracyclines and platinum agents. There is a particular advantage of this regimen over taxane-based regimens, including minimal neuropathy, less use of steroids and low risk of allergic reaction and alopecia.
authors: The Cancer Center, University Hospitals of Birmingham NHS Trust, Birmingham, U.K. syed.tirmazy@nhs.net.
authors: Syed Hammad
authors: SH
authors: Tirmazy
authors: The Cancer Center, University Hospitals of Birmingham NHS Trust, Birmingham, U.K.
authors: Urmila
authors: U
authors: Barthakur
authors: The Cancer Center, University Hospitals of Birmingham NHS Trust, Birmingham, U.K.
authors: Ahmed
authors: A
authors: El-Modir
authors: The Cancer Center, University Hospitals of Birmingham NHS Trust, Birmingham, U.K.
authors: Suhail
authors: S
authors: Anwar
authors: The Cancer Center, University Hospitals of Birmingham NHS Trust, Birmingham, U.K.
authors: Indrajit
authors: I
authors: Fernando
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D016889:Endometrial Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies
chemical_list: D015251:Epirubicin; D016190:Carboplatin
keywords: Endometrial cancer; carboplatin; chemotherapy; epirubicin