Patterns of Disease Relapses in Patients with High-risk Endometrial Carcinoma Following Concurrent Chemoradiation with Paclitaxel

Document Type : Original research articles

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Department of Radiation Oncology and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.

Abstract

Background: Women with high-risk endometrial cancer have a relatively higher recurrence rates and poor prognosis following hysterectomy alone. Adjuvant radiotherapy and chemotherapy had been proposed to improve these outcomes. Patterns of relapse are influenced by adjuvant treatment received and other clinical and pathological factors.
Objectives: Analysis of patterns of relapse in patients with high-risk endometrial carcinoma after Concurrent chemoradiation (CCRT) versus radiotherapy alone (RTH).
Patients and methods: This is a randomized controlled trial (RCT) of patients with high risk endometrial carcinoma. Patients are divided into two arms: Arm A received weekly paclitaxel and pelvic radiotherapy, Arm B radiotherapy alone. During follow-up; disease relapses were recorded regarding time of failure, site of disease relapse and survivals data.
Results: Seventy-one patients were includedin the study; 34 patients received CCRT; and 37 patients received RTH alone. Thirteen patients [18.3%] had a treatment failure; treatment failures are more in RTH group, but without statistical significance [p-value =0.51]; 2 patients had loco-regional failure, 8 patients had distant metastases and 3 patients had both regional and distant failure.Estimated 2-years OS was around 86% with no statistical significance between both treatment arms [p-value = 0.83], and estimated 2-years DFS was; 83.2% for CCRT arm and 77.1% for RTH arm, with no statistical significance [p-value = 0.48].Other disease and treatment related factors didn’t show statistical significance regarding disease relapses.
Conclusion: Adding concurrent paclitaxel to pelvic radiotherapy did not decrease disease relapse in high-risk endometrial cancers.

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