Department of Obstetrics and Gynecology, Daejeon St Mary's Hospital, College of Medicine, 65399The Catholic University of Korea, Daejeon, South Korea.
Department of Obstetrics and Gynecology, Uijeongbu St Mary's Hospital, College of Medicine, 65682The Catholic University of Korea, Uijeongbu, South Korea.
Cancer Control. 2022 Jan-Dec;29:10732748221115288. doi: 10.1177/10732748221115288.
We aimed to evaluate the efficacy and toxicity of the combination of 6 cycles of chemotherapy and radiation therapy compared with chemotherapy alone as postoperative adjuvant therapy for patients with stage III endometrial cancer.
This retrospective cohort study included patients with stage III endometrial cancer who received postoperative chemoradiotherapy or chemotherapy alone at 6 hospitals between January 2009 and December 2019. The progression-free survival (PFS) and overall survival (OS) for each treatment group were analyzed using the Kaplan-Meier method. We also assessed differences in toxicity profiles between the treatment groups.
A total of 133 patients met the inclusion criteria. Of these, 80 patients (60.2%) received adjuvant chemoradiotherapy and 53 (39.8%) received chemotherapy alone. The PFS and OS did not differ significantly between the groups. For patients with stage IIIC endometrioid subtype, the chemoradiotherapy group had significantly longer PFS rate than did the chemotherapy alone group (log-rank test, = .019), although there was no significant difference in the OS (log-rank test, = .100). CRT was identified as a favorable prognostic factor for PFS in multivariate analysis (adjusted HR, .37; 95% CI, .16-.87; = .022). Patients treated with chemoradiotherapy more frequently suffered from grade 4 neutropenia (73.8% vs 52.8%; = .018) and grade 3 or worse thrombocytopenia (36.3% vs 9.4%; = .001) compared with the chemotherapy alone group. There were no differences between the 2 treatment groups in the frequency of toxicity-related treatment discontinuation or dose reduction.
We confirmed that chemoradiotherapy yields longer progression-free survival than does chemotherapy alone for patients with stage IIIC endometrioid endometrial cancer, with an acceptable toxicity profile.
我们旨在评估与单纯化疗相比，6 个周期化疗联合放疗作为 III 期子宫内膜癌术后辅助治疗的疗效和毒性。
这项回顾性队列研究纳入了 2009 年 1 月至 2019 年 12 月期间在 6 家医院接受术后放化疗或单纯化疗的 III 期子宫内膜癌患者。使用 Kaplan-Meier 法分析每个治疗组的无进展生存期（PFS）和总生存期（OS）。我们还评估了两组之间毒性谱的差异。
共纳入 133 例符合条件的患者。其中 80 例（60.2%）接受辅助放化疗，53 例（39.8%）接受单纯化疗。两组间 PFS 和 OS 无显著差异。对于 IIIC 期子宫内膜样亚型患者，放化疗组的 PFS 率明显长于单纯化疗组（对数秩检验，=.019），但 OS 无显著差异（对数秩检验，=.100）。多因素分析显示 CRT 是 PFS 的有利预后因素（调整 HR，.37；95%CI，.16-.87；=.022）。与单纯化疗组相比，放化疗组更常发生 4 级中性粒细胞减少症（73.8% vs 52.8%；=.018）和 3 级或更严重血小板减少症（36.3% vs 9.4%；=.001）。两组间因毒性相关停药或剂量减少的频率无差异。
我们证实，与单纯化疗相比，放化疗可使 IIIC 期子宫内膜样子宫内膜癌患者获得更长的无进展生存期，且毒性谱可接受。
