Journal article
Radiation Therapy With or Without Cisplatin for Local Recurrences of Endometrial Cancer: Results From an NRG Oncology/GOG Prospective Randomized Multicenter Clinical Trial
Journal of clinical oncology, Vol.42(20), pp.2425-2435
04/25/2024
DOI: 10.1200/JCO.23.01279
PMCID: PMC11681946
PMID: 38662968
Abstract
Pelvic recurrence is a frequent pattern of relapse for women with endometrial cancer. A randomized trial compared progression-free survival (PFS) after treatment with radiation therapy alone as compared with concurrent chemotherapy.
Between February 2008 and August 2020, 165 patients were randomly assigned 1:1 to receive either radiation treatment alone or a combination of chemotherapy and radiation treatment. The primary objective of this study was to determine whether chemoradiation therapy was more effective than radiation therapy alone at improving PFS.
The majority of patients had low-grade (1 or 2) endometrioid histology (82%) and recurrences confined to the vagina (86%). External beam with either the three-dimensional or intensity modulated radiation treatment technique was followed by a boost delivered with brachytherapy or external beam. Patients randomly assigned to receive chemotherapy were treated with once weekly cisplatin (40 mg/m
). Rates of acute toxicity were higher in patients treated with chemoradiation as compared with radiation treatment alone. Median PFS was longer for patients treated with radiation therapy alone as compared with chemotherapy and radiation (median PFS was not reached for RT
73 months for chemoradiation, hazard ratio of 1.25 (95% CI, 0.75 to 2.07). At 3 years, 73% of patients treated definitively with radiation and 62% of patients treated with chemoradiation were alive and free of disease progression.
Excellent outcomes can be achieved for women with localized recurrences of endometrial cancer when treated with radiation therapy. The addition of chemotherapy does not improve PFS for patients treated with definitive radiation therapy for recurrent endometrial cancer and increases acute toxicity. Patients with low-grade and vaginal recurrences who constituted the majority of those enrolled are best treated with radiation therapy alone.
Details
- Title: Subtitle
- Radiation Therapy With or Without Cisplatin for Local Recurrences of Endometrial Cancer: Results From an NRG Oncology/GOG Prospective Randomized Multicenter Clinical Trial
- Creators
- Ann H Klopp - The University of Texas MD Anderson Cancer CenterDanielle Enserro - Roswell Park Comprehensive Cancer CenterMatthew Powell - Washington University in St. Louis School of MedicineMarcus Randall - University of KentuckyJulian C Schink - Cancer Treatment Centers of AmericaRobert S Mannel - University of OklahomaLaura Holman - University of OklahomaDavid Bender - University of IowaChristina L Kushnir - Women's Cancer Center of NevadaFloor Backes - The Ohio State University Wexner Medical CenterSusan L Zweizig - University of Massachusetts Chan Medical SchoolSteven Waggoner - Cleveland ClinicKristin A Bradley - UW Health University HospitalLana DeSouza Lawrence - Christiana Care Health SystemParviz Hanjani - Abington Memorial HospitalChristopher J Darus - Maine Medical CenterWilliam Small Jr - Loyola University ChicagoHiginia R Cardenes - Weill Cornell MedicineJonathan M Feddock - New England Baptist HospitalDavid S Miller - The University of Texas Southwestern Medical Center
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.42(20), pp.2425-2435
- DOI
- 10.1200/JCO.23.01279
- PMID
- 38662968
- PMCID
- PMC11681946
- NLM abbreviation
- J Clin Oncol
- eISSN
- 1527-7755
- Grant note
- U10 CA180822 / NCI NIH HHS U10 CA180868 / NCI NIH HHS
- Language
- English
- Electronic publication date
- 04/25/2024
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9984618501002771
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