Concomitant paclitaxel plus carboplatin and radiotherapy for high-risk or advanced endometrial cancer

The objective of this study was to evaluate the outcome and feasibility of concurrent chemotherapy with paclitaxel plus carboplatin and radiotherapy (RT) in patients with high-risk or advanced endometrial cancer.

A retrospective analysis of patients treated between January 2003 and December 2009 was conducted. Adjuvant therapy consisted of external beam radiation to the pelvis (45-48.6 Gy) and weekly administration of paclitaxel (40 mg/m(2)) plus carboplatin with an area under the curve of 2 administered intravenously during RT. Two further cycles of paclitaxel (175 mg/m(2)) and carboplatin (area under the curve, 5), separated by 4 weeks, were administered at the end of RT for advanced stage disease. Para-aortic RT and/or vault brachytherapy were added at the discretion of the physicians.

A total of 31 patients with a median age of 56 years (31-69 years) were evaluated. The majority had stage III disease (58%), and the most common histology was endometrioid adenocarcinoma (78%). All patients completed the planned RT. The median follow-up time was 64 months (12-86 months). Five patients' conditions progressed, and all 5 died of the disease. Most of the 5 patients were with serous histologic type and advanced stage disease. There was no local recurrence. The 2-, 3-, and 5-year progression-free survival rates were 87%, 84%, and 79%, respectively. The 2-, 3-, and 5-year overall survival rates were 94%, 87%, and 83%, respectively. Toxicity included grade 3/4 neutropenia in 45.2% of patients, gastrointestinal toxicity in 32.3% of patients, and grade 1/2 sensory neuropathy in 38.7% of patients.

Concomitant paclitaxel plus carboplatin and radiation was feasible and well tolerated and resulted in excellent local-regional control. However, distant metastases continued to occur in more advanced-stage patients. This regimen appears reasonable to be tested for efficacy in randomized studies.