RT  - European Journal of Gynaecological Oncology
ID  - 10.31083/j.ejgo4204103
T1  - Sequential chemotherapy-radiotherapy as adjuvant treatment of high-risk endometrial carcinoma: a retrospective review of the Manchester experience
A1  - Reem D. Mahmood
A1  - Robert D. Morgan
A1  - Tine Descamps
A1  - Claire Mitchell
A1  - Jurjees Hasan
A1  - Nerissa Mescallado
A1  - Lisa Barraclough
A1  - Kate Haslett
A1  - Jacqueline Livsey
A1  - Emma J. Crosbie
A1  - Richard J. Edmondson
A1  - Gordon C. Jayson
A1  - Andrew R. Clamp
K1  - Endometrial cancer; Chemotherapy; Radiotherapy; Brachytherapy
YR  - 2021
SP  - 673
AB  - <p><i>Objective</i>: The optimum sequencing of adjuvant treatment in patients with high-risk endometrial cancer remains contentious. Here, we report the outcomes of women treated in Manchester, United Kingdom, where sequential chemotherapy-radiotherapy is the standard adjuvant treatment approach for these patients. <i>Methods</i>: A retrospective analysis was carried out on 106 consecutive patients referred for adjuvant treatment of high-risk endometrial cancer in 2014 and 2015. High-risk endometrial cancer was defined as: International Federation of Gynaecology and Obstetrics (2009) stage I grade 3 endometrioid carcinoma with deep myometrial invasion and/or lymphovascular space invasion, stage II–III endometrioid carcinoma, or any other histological subtype with stage I–III disease. Adjuvant treatment included carboplatin (AUC5) and paclitaxel (175 mg/m<span style="font-size: 12px; vertical-align: super;">2</span>) every 21 days for 4/6 cycles, followed by external beam pelvic radiotherapy (40 Gy in 20 fractions#) or vaginal brachytherapy (28 Gy in 2 fractions#) or both. Primary outcome measures were recurrence free survival (RFS), overall survival (OS) and treatment-related toxicity. <i>Results</i>: Seventy-nine percent of patients were treated with sequential chemotherapy-radiotherapy. After a median follow-up of 64.4 months, 5-year RFS was 70% (95% CI 60.8–80.6%) and 5-year OS was 71.4% (95% CI 62.3–81.7%). Single modality adjuvant therapy was given for patient choice or contra-indications to treatment. Patients tolerated sequential treatment well; 96% of patients completed all treatment and 20% of patients had <inline-formula>≥<math><mo>≥</mo></math></inline-formula>grade 3 adverse events. <i>Conclusions</i>: Sequential chemotherapy-radiotherapy as adjuvant treatment for high-risk endometrial cancer was tolerable and was associated with survival outcomes consistent with recent international phase III clinical trials.</p><p><br></p>