Comparison of postoperative radiotherapy versus postoperative paclitaxel and platinum chemotherapy in uterine endometrial carcinoma

Choi, Min Chul; Park, Ji Hyeon; Kim, Su Hyun; Jun, Kyung Hun; Jung, Sang Geun; Na, Young Jeong; Lee, Sun Young; Lee, Chan; Hwang, Yeun Young; Kim, Seung Jo

Abstract

OBJECTIVE
This study was performed to compare postoperative adjuvant paclitaxel and platinum (TC) chemotherapy and radiation therapy in women with uterine endometrial carcinoma.
METHODS
Total one hundred five patients were entered into this trial. Non-endometrioid histologic subtypes such as serous, clear cell and small cell types were excluded from the study because they have different biological potentials. Of 58 assessable patients, who were needed adjuvant treatment according to surgico-pathologic reports, after surgery, 34 were received TC chemotherapy and 24 were received radiation therapy. Chemotherapy consisted of paclitaxel 175 mg/m2 and carboplatin AUC 5 (or cisplatin 50 mg/m2) every 3 weeks for 3 or 6 cycles. Irradiation dosage was 4,500~5,040 cGy in 28 fractions.
RESULTS
In 58 evaluated patients, median follow-up time was 40.3 months (range 7~64 months). The 5-year overall survival and 5-year disease-free survival were 91.3% and 91.0% in 34 patients treated with TC chemotherapy, and 91.4% and 82.8% in 24 cases who treated with radiation therapy, however, there were no significant difference (P=0.646, P=0.129). The most common adverse effect of TC chemotherapy was hematologic toxicity, which was manageable conservatively. The serious gastrointestinal complication of radiotherapy was noted in 5 patients (20.8%), three of these patients were received another bowel surgery, such as ileo-cecal bypass, however, symptoms were persisted after surgery.
CONCLUSIONS
These data suggest that postoperative adjuvant TC chemotherapy is a promising treatment which could be substituted for radiation therapy, with major activity and a acceptable toxicity profile for the treatment of uterine endometrial carcinoma.