Sequencing of treatment affected outcomes in advanced-stage endometrial cancer

SGO 40th Annual Meeting on Women's Cancer

Compared with other sequencing modalities chemotherapy followed by radiation and then chemotherapy, or CRC, improved survival among women with stage-III and -IV endometrial cancer, according to data presented at the Society of Gynecologic Oncologists’ 40th Annual Meeting on Women’s Cancer.

“After adjusting for age, grade, histologic subtype, stage and debulking status, we found that women who were treated by radiation followed by chemotherapy were at a 5.5-fold increased risk of dying. And those treated with chemotherapy followed by radiation had a 2.6-fold increased risk of dying compared with those who were treated with CRC,” Angeles Alvarez Secord, MD, department of gynecologic oncology, Duke University Medical Center, North Carolina, said during her presentation.

The multicenter, retrospective study included 109 patients with advanced-stage endometrial cancer who underwent a comprehensive staging procedure. All patients received postoperative therapy, including: CRC (41%), radiation followed by chemotherapy (17%) and chemotherapy followed by radiation (42%).

The researchers reported no differences in adverse event frequency due to chemotherapy (P=.35) or radiation (P=.14), or dose modifications (P=.055) between the different modalities. However, patients who received CRC had superior three-year OS (88%) and PFS (69%) compared with patients who received radiation then chemotherapy (OS=54%; PFS=47%) and chemotherapy then radiation (OS=57%; PFS=52%).

Future clinical trials are needed to prospectively evaluate appropriate sequencing of chemotherapy and radiotherapy for the treatment of advanced stage endometrial cancer. – by Stacey L. Adams

For more information:

Alvarez Secord A. #23. Presented at: Society for Gynecologic Oncologists’ 40th Annual Meeting on Women’s Cancer; Feb. 5-8, 2009; San Antonio.