Chemo- and Radiotherapy in Adjuvant Management of Optimally Debulked Endometrial Cancer

View More View Less
  • a From the University of Texas Southwestern Medical Center, Dallas, Texas; University of Chicago Medical Center, Chicago, Illinois; and Department of Radiation Medicine, University of Kentucky School of Medicine, Lexington, Kentucky.

The role of chemotherapy and radiotherapy in adjuvant management of optimally debulked endometrial cancer with extrauterine involvement is evolving. Recent studies have suggested an expanded role for chemotherapy and questioned the benefit of radiation therapy. Ongoing and planned clinical trials should provide clarification.

If the inline PDF is not rendering correctly, you can download the PDF file here.

Dr. Miller is a principal investigator for Gynecologic Oncology Group (GOG) Protocol 209. Dr. Fleming is a principal investigator for a study partially funded by Wyeth, and is a principal investigator for 2 GOG trials; she is also on the GOG board of directors and Gynecologic Cancer Steering Committee. Dr. Randall has no financial interests, arrangement, or affiliations with the manufacturers of any products discussed in the article or their competitors.

Correspondence: Marcus E. Randall, MD, Department of Radiation Medicine, University of Kentucky School of Medicine, 800 Rose Street, Room N14, Lexington, KY 40536-0293. E-mail: merand2@email.uky.edu
  • 1

    Randall ME, Filiaci VL, Muss H. Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 2006;24:3644.

    • Search Google Scholar
    • Export Citation
  • 2

    Maggi R, Lissoni A, Spina F. Adjuvant chemotherapy vs radiotherapy in high-risk endometrial carcinoma: results of a randomised trial. Br J Cancer 2006;95:266271.

    • Search Google Scholar
    • Export Citation
  • 3

    Alvarez Secord A, Havrilesky LJ, Bae-Jump V. The role of multi-modality adjuvant chemotherapy and radiation in women with advanced stage endometrial cancer. Gynecol Oncol 2007;107:285291.

    • Search Google Scholar
    • Export Citation
  • 4

    Susumu N, Sagae S, Udagawa Y. Randomized phase III trial of pelvic radiotherapy versus cisplatin-based combined chemotherapy in patients with intermediate- and high-risk endometrial cancer: a Japanese Gynecologic Oncology Group study. Gynecol Oncol 2008;108:226233.

    • Search Google Scholar
    • Export Citation
  • 5

    Aoki Y, Kase H, Watanabe M. Stage III endometrial cancer: analysis of prognostic factors and failure patterns after adjuvant chemotherapy. Gynecol Oncol 2001;83:15.

    • Search Google Scholar
    • Export Citation
  • 6

    Murphy KT, Rotmensch J, Yamada SD, Mundt AJ. Outcome and patterns of failure in pathologic stages I-IV clear-cell carcinoma of the endometrium: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys 2003;55:12721276.

    • Search Google Scholar
    • Export Citation
  • 7

    McMeekin DS, Lashbrook D, Gold M. Analysis of FIGO Stage IIIc endometrial cancer patients. Gynecol Oncol 2001;81:273278.

  • 8

    Selman AE, Fowler JM, Martinez-Monge R, Copeland LJ. Doxorubicin and/or cisplatin based chemotherapy for the treatment of endometrial carcinoma with retroperitoneal lymph node metastases. Int J Gynecol Cancer 1998;8:423442.

    • Search Google Scholar
    • Export Citation
  • 9

    Morrow CP, Bundy BN, Homesley HD. Doxorubicin as an adjuvant following surgery and radiation therapy in patients with high-risk endometrial carcinoma, stage I and occult stage II: a Gynecologic Oncology Group study. Gynecol Oncol 1990;36:166171.

    • Search Google Scholar
    • Export Citation
  • 10

    Kuoppala T, Maenpaa J, Tomas E. Surgically staged high-risk endometrial cancer: randomized study of adjuvant radiotherapy alone vs. sequential chemo-radiotherapy. Gynecol Oncol 2008;110:190195.

    • Search Google Scholar
    • Export Citation
  • 11

    Hogberg T, Rosenberg P, Kristensen G. A randomized phase-III study on adjuvant treatment with radiation (RT) + chemotherapy (CT) in early-stage high-risk endometrial cancer (NSGO-EC-9501/EORTC 55991) [abstract]. J Clin Oncol 2007;25(Suppl 1):Abstract 5503.

    • Search Google Scholar
    • Export Citation
  • 12

    Homesley HD, Filiaci V, Gibbons SK. A randomized phase III trial in advanced endometrial carcinoma of surgery and volume directed radiation followed by cisplatin and doxorubicin with or without paclitaxel: a Gynecologic Oncology Group study. Gynecol Oncol 2009;112:543552.

    • Search Google Scholar
    • Export Citation
  • 13

    Fleming GF, Brunetto VL, Cella D. Phase III trial of doxorubicin plus cisplatin with or without paclitaxel plus filgrastim in advanced endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 2004;22:21592166.

    • Search Google Scholar
    • Export Citation
  • 14

    Gien L, Kwon J, Oliver TK, Fung-Kee-Fung M. Adjuvant hormonal therapy for stage I endometrial cancer. Curr Oncol 2008;15:126135.

  • 15

    Martin-Hirsch PL, Jarvis G, Kitchener J, Lilford R. Progestagens for endometrial cancer. Cochrane Database Syst Rev 2000;CD001040.

  • 16

    Singh M, Zaino RJ, Filiaci VJ, Leslie KK. Relationship of estrogen and progesterone receptors to clinical outcome in metastatic endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2007;106:325333.

    • Search Google Scholar
    • Export Citation
  • 17

    Thigpen JT, Brady MF, Alvarez RD. Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose-response study by the Gynecologic Oncology Group. J Clin Oncol 1999;17:17361744.

    • Search Google Scholar
    • Export Citation
  • 18

    Lentz SS, Brady MF, Major FJ. High-dose megestrol acetate in advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 1996;14:357361.

    • Search Google Scholar
    • Export Citation
  • 19

    Fiorica JV, Brunetto VL, Hanjani P. Phase II trial of alternating courses of megestrol acetate and tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Gynecol Oncol 2004;92:1014.

    • Search Google Scholar
    • Export Citation
  • 20

    Creasman WT, Odicino F, Maisonneuve P. Carcinoma of the corpus uteri. Int J Gynaecol Obstet 2003;83(Suppl 1):79118.

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 63 19 4
PDF Downloads 36 19 1
EPUB Downloads 0 0 0