Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia.
Oncology Center, Mansoura University, Mansoura, Egypt.
Asian Pac J Cancer Prev. 2020 May 1;21(5):1327-1332. doi: 10.31557/APJCP.2020.21.5.1327.
The role of combined modality in the adjuvant treatment of Endometrial Cancer has not been established. This study aims to assess the benefits of Sequential Chemoradiotherapy (SCRT) compared to Radiotherapy (RT) alone in the treatment of patients with Endometrial Cancer.
Retrospective analysis of patients with Endometrial Cancer stage I to stage III C at King Abdullah Medical city, Makkah. Each group of patients was assigned to receive External pelvic RT, brachytherapy or both. While a second group received SCRT consisting of six cycles of Carboplatin (AUC 5) and Paclitaxel 175 mg/m2 followed by radiotherapy.
Fifty-six women were treated of which 26 received SCRT and 30 received RT. The two groups had a median age of 58 years old ranging from 34 - 84 years old with no other statistically significant difference. Patients who received SCRT had poorer prognostic tumor characteris-tics. Median follow-up was 29.6 months (95% CI: 19.6-39.5 months). All deaths (n=5) were exclusively in the RT group. The 2 and 4-year OS rates were 100% and 100% in SCRT group versus 87.3% and 64.9% in RT group (hazard ratio [HR] 0.018 [95% CI: 0-24.4; p= 0.038); The 2- and 4-year DFS were 100% and 100% in SCRT group versus 78.1% and 43.9% in RT group (HR 0.102 [95% CI: 0.103-0.805; p= 0.008).
Adjuvant chemotherapy given before radiotherapy for Endometrial Cancer may lessen the effect of high-risk features on the DFS and OS. Randomized clinical trials are needed to determine the benefits of early Systemic Therapy.
联合治疗模式在子宫内膜癌辅助治疗中的作用尚未确定。本研究旨在评估与单独放疗相比，序贯放化疗（SCRT）在治疗子宫内膜癌患者中的益处。
回顾性分析了位于麦加阿卜杜拉国王医疗城的 I 期至 III 期 C 期子宫内膜癌患者。每组患者被分配接受外部骨盆放疗、近距离放疗或两者联合治疗。而第二组患者接受包含六个周期卡铂（AUC5）和紫杉醇 175mg/m2 的 SCRT 治疗，然后进行放疗。
共治疗了 56 名女性，其中 26 名患者接受了 SCRT，30 名患者接受了 RT。两组患者的中位年龄为 58 岁，年龄范围为 34-84 岁，无其他统计学显著差异。接受 SCRT 的患者具有较差的预后肿瘤特征。中位随访时间为 29.6 个月（95%CI：19.6-39.5 个月）。所有死亡（n=5）均发生在 RT 组。SCRT 组的 2 年和 4 年 OS 率分别为 100%和 100%，而 RT 组的 2 年和 4 年 OS 率分别为 87.3%和 64.9%（风险比[HR]0.018[95%CI：0-24.4;p=0.038）；SCRT 组的 2 年和 4 年 DFS 率分别为 100%和 100%，而 RT 组的 2 年和 4 年 DFS 率分别为 78.1%和 43.9%（HR0.102[95%CI：0.103-0.805;p=0.008）。
在放疗前给予子宫内膜癌辅助化疗可能会降低高危特征对 DFS 和 OS 的影响。需要进行随机临床试验来确定早期系统治疗的益处。
