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A Phase 2 Trial of Radiation Therapy With Concurrent Paclitaxel Chemotherapy After Surgery in Patients With High-Risk Endometrial Cancer: A Korean Gynecologic Oncologic Group Study

      Purpose

      A phase 2 study was completed by the Korean Gynecologic Oncologic Group to evaluate the efficacy and toxicity of concurrent chemoradiation with weekly paclitaxel in patients with high-risk endometrial cancer.

      Methods and Materials

      Pathologic requirements included endometrial endometrioid adenocarcinoma stages III and IV. Radiation therapy consisted of a total dose of 4500 to 5040 cGy in 5 fractions per week for 6 weeks. Paclitaxel 60 mg/m2 was administered once weekly for 5 weeks during radiation therapy.

      Results

      Fifty-seven patients were enrolled between January 2006 and March 2008. The median follow-up time was 60.0 months (95% confidence interval [CI], 51.0-58.2). All grade 3/4 toxicities were hematologic and usually self-limited. There was no life-threatening toxicity. The cumulative incidence of intrapelvic recurrence sites was 1.9% (1/52), and the cumulative incidence of extrapelvic recurrence sites was 34.6% (18/52). The estimated 5-year disease-free and overall survival rates were 63.5% (95% CI, 50.4-76.5) and 82.7% (95% CI, 72.4-92.9), respectively.

      Conclusions

      Concurrent chemoradiation with weekly paclitaxel is well tolerated and seems to be effective for high-risk endometrioid endometrial cancers. This approach appears reasonable to be tested for efficacy in a prospective, randomized controlled study.
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      References

        • Jemal A.
        • Bray F.
        • Center M.M.
        • et al.
        Global cancer statistics.
        CA Cancer J Clin. 2011; 61: 69-90
        • Kuwabara Y.
        • Susumu N.
        • Banno K.
        • et al.
        Clinical characteristics of prognostic factors in poorly differentiated (G3) endometrioid adenocarcinoma in Japan.
        Jpn J Clin Oncol. 2005; 35: 23-27
        • Aalders J.
        • Abeler V.
        • Kolstad P.
        • et al.
        Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: Clinical and histopathologic study of 540 patients.
        Obstet Gynecol. 1980; 56: 419-427
        • Thigpen J.T.
        • Brady M.F.
        • Homesley H.D.
        • et al.
        Phase III trial of doxorubicin with or without cisplatin in advanced endometrial carcinoma: A Gynecologic Oncology Group study.
        J Clin Oncol. 2004; 22: 3902-3908
        • Mundt A.J.
        • McBride R.
        • Rotmensch J.
        • et al.
        Significant pelvic recurrence in high-risk pathologic stage I-IV endometrial carcinoma patients after adjuvant chemotherapy alone: Implications for adjuvant radiation therapy.
        Int J Radiat Oncol Biol Phys. 2001; 50: 1145-1153
        • Alvarez Secord A.
        • Havrilesky L.J.
        • Bae-Jump V.
        • et al.
        The role of multi-modality adjuvant chemotherapy and radiation in women with advanced stage endometrial cancer.
        Gynecol Oncol. 2007; 107: 285-291
        • Choy H.
        • Rodriguez F.F.
        • Koester S.
        • et al.
        Investigation of taxol as a potential radiation sensitizer.
        Cancer. 1993; 71: 3774-3778
        • Frigerio L.
        • Mangili G.
        • Aletti G.
        • et al.
        Concomitant radiotherapy and paclitaxel for high-risk endometrial cancer: First feasibility study.
        Gynecol Oncol. 2001; 81: 53-57
        • Vogt H.G.
        • Martin T.
        • Kolotas C.
        • et al.
        Simultaneous paclitaxel and radiotherapy: Initial clinical experience in lung cancer and other malignancies.
        Semin Oncol. 1997; 24 (S112-105): S12-S101
        • Randall M.E.
        • Filiaci V.L.
        • Muss H.
        • et al.
        Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: A Gynecologic Oncology Group study.
        J Clin Oncol. 2006; 24: 36-44
        • Sutton G.
        • Axelrod J.H.
        • Bundy B.N.
        • et al.
        Whole abdominal radiotherapy in the adjuvant treatment of patients with stage III and IV endometrial cancer: A Gynecologic Oncology Group study.
        Gynecol Oncol. 2005; 97: 755-763
        • Hoskins P.J.
        • Swenerton K.D.
        • Pike J.A.
        • et al.
        Paclitaxel and carboplatin, alone or with irradiation, in advanced or recurrent endometrial cancer: A phase II study.
        J Clin Oncol. 2001; 19: 4048-4053
        • Aoki Y.
        • Kase H.
        • Watanabe M.
        • et al.
        Stage III endometrial cancer: Analysis of prognostic factors and failure patterns after adjuvant chemotherapy.
        Gynecol Oncol. 2001; 83: 1-5
        • Greven K.
        • Winter K.
        • Underhill K.
        • et al.
        Final analysis of RTOG 9708: Adjuvant postoperative irradiation combined with cisplatin/paclitaxel chemotherapy following surgery for patients with high-risk endometrial cancer.
        Gynecol Oncol. 2006; 103: 155-159
        • Lissoni A.
        • Zanetta G.
        • Losa G.
        • et al.
        Phase II study of paclitaxel as salvage treatment in advanced endometrial cancer.
        Ann Oncol. 1996; 7: 861-863
        • Woo H.L.
        • Swenerton K.D.
        • Hoskins P.J.
        Taxol is active in platinum-resistant endometrial adenocarcinoma.
        Am J Clin Oncol. 1996; 19: 290-291
        • Aapro M.S.
        • van Wijk F.H.
        • Bolis G.
        • et al.
        Doxorubicin versus doxorubicin and cisplatin in endometrial carcinoma: Definitive results of a randomised study (55872) by the EORTC Gynaecological Cancer Group.
        Ann Oncol. 2003; 14: 441-448
        • Choy H.
        • Akerley W.
        • Safran H.
        • et al.
        Phase I trial of outpatient weekly paclitaxel and concurrent radiation therapy for advanced non-small-cell lung cancer.
        J Clin Oncol. 1994; 12: 2682-2686
        • Wolf M.
        • Faoro C.
        • Goerg C.
        • et al.
        Paclitaxel and simultaneous radiation in the treatment of stage IIIA/B non-small cell lung cancer.
        Semin Oncol. 1996; 23: 108-112
        • Jhingran A.
        • Ramondetta L.M.
        • Bodurka D.C.
        • et al.
        A prospective phase II study of chemoradiation followed by adjuvant chemotherapy for FIGO stage I-IIIA (1988) uterine papillary serous carcinoma of the endometrium.
        Gynecol Oncol. 2013; 129: 304-309
        • Fowler J.M.
        • Brady W.E.
        • Grigsby P.W.
        • et al.
        Sequential chemotherapy and irradiation in advanced stage endometrial cancer: A Gynecologic Oncology Group phase I trial of doxorubicin-cisplatin followed by whole abdomen irradiation.
        Gynecol Oncol. 2009; 112: 553-557
        • De Marzi P.
        • Frigerio L.
        • Cipriani S.
        • et al.
        Adjuvant treatment with concomitant radiotherapy and chemotherapy in high-risk endometrial cancer: A clinical experience.
        Gynecol Oncol. 2010; 116: 408-412

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