Comparison of the efficacy between paclitaxel/carboplatin and doxorubicin/cisplatin for concurrent chemoradiation in intermediate‐ or high‐risk endometrioid endometrial cancer: A single institution experience

Abstract

Aim:We sought to compare survival and toxicity between paclitaxel/carboplatin (TC) and doxorubicin/ cisplatin (AP) for concurrent chemoradiation (CCR) in intermediate-or high-risk endometrioid endometrial cancer. Methods: The clinical data of 40 patients with intermediate-(FIGO stage IC-IIB, n = 12) or high-risk endometrioid endometrial cancer (FIGO stage IIIA-IVA, n = 28) were reviewed retrospectively between March 2000 and December 2007, who were treated with TC (n = 23, group 1) or AP (n = 17, group 2) for CCR after surgery. Results: Progression-free survival (PFS) and overall survival (OS) were not different between groups 1 and 2 (median PFS and OS; 35 vs 24 and 76 vs 39 months, respectively, P > 0.05). However, Ն6 cycles of chemotherapy improved PFS compared with 3-5 cycles of chemotherapy (51 vs 21 months, P = 0.04), suggesting that Ն6 cycles of chemotherapy was an independent prognostic factor improving PFS (adjusted HR, 0.27; 95% CI, 0.08 to 0.91; P = 0.04). Grade 3 or 4 hematological and non-hematological, especially, gastrointestinal, toxicities related with chemotherapy during CCR were more common in group 2 than in group 1, whereas there was no difference in grade 3 or 4 late complication by CCR between the 2 groups. Conclusion: These findings suggest that TC may have comparable efficacy to AP for CCR with lesser toxicity, and Ն6 cycles of chemotherapy may be more beneficial than 3-5 cycles of chemotherapy in intermediate-or high-risk endometrioid endometrial cancer. However, large-scale randomized controlled trials are needed to support these results.

Predictors of Survival in Women with High-Risk Endometrial Cancer and Comparisons of Sandwich versus Concurrent Adjuvant Chemotherapy and Radiotherapy

“…In addition, the patients received two cycles of cisplatin and four cycles of carboplatin/paclitaxel in the PORTEC-3 trial [ 2 ]. Kim et al also reported that ≥6 cycles of chemotherapy may be more beneficial than 3–5 cycles of chemotherapy for high-risk endometrioid EC patients [ 21 ]. Nonetheless, Mayam et al reported that four cycles of chemotherapy may be suitable for high-risk EC patients due to low incidence of hematologic toxicities without impairing survival compared with six cycles [ 22 ].…”

Pure large cell neuroendocrine carcinoma originating from the endometrium: A case report

“…Paclitaxel and platinum-based chemotherapy has become a first-line chemotherapy regimen for gynecological malignant tumors such as endometrial cancer and ovarian cancer, especially for patients with aggressive tumors who have a high risk of recurrence. Lobaplatin is more effective for controlling disease progression and associated with less toxicity and better patient quality of life than carboplatin[ 25 , 26 ]. Therefore, this patient was treated with liposomal paclitaxel combined with lobaplatin, which achieved good efficacy with mild side effects.…”

Increased Incidence of Severe Gastrointestinal Events With First-Line Paclitaxel, Carboplatin, and Vorinostat Chemotherapy for Advanced-Stage Epithelial Ovarian, Primary Peritoneal, and Fallopian Tube Cancer

“…27 Paclitaxel and carboplatin are both associated with mild gastrointestinal toxicity, but neither agent typically coincides with the development of a bowel perforation 27,28 ; nevertheless, previous studies have documented that bowel perforations occur in approximately 2.5% of patients treated with paclitaxel. 29,30 Furthermore, the patients in the current case study received weekly paclitaxel, which allegedly induces an antiangiogenic effect that may compromise wound healing. 31 Because paclitaxel and carboplatin are not characteristically recognized as causative agents in the development of a bowel anastomotic perforation or fistula development, we must consider vorinostat as a possible contributory factor when considering the patients' significant gastrointestinal events.…”