J Gynecol Oncol.  2012 Jan;23(1):22-27. 10.3802/jgo.2012.23.1.22.

Sequential chemotherapy and radiotherapy as sandwich therapy for the treatment of high risk endometrial cancer

• Abaid LN
• Rettenmaier MA
• Brown JV
• Micha JP
• Mendivil A
• Wabe MA
• Goldstein

• KMID: 2177510
• DOI: http://doi.org/10.3802/jgo.2012.23.1.22

Abstract

OBJECTIVE
The purpose of this retrospective study was to assess the tolerability and efficacy of sequential chemotherapy and radiotherapy for the treatment of high risk endometrial cancer.
METHODS
We conducted a retrospective study of previously untreated high risk endometrial cancer patients who received sequential chemotherapy and radiotherapy in accordance with the sandwich approach from June 2008 until June 2011. High risk endometrial cancer patients underwent complete surgical staging followed by adjuvant therapy encompassing sequential chemotherapy, radiation therapy and consolidation chemotherapy.
RESULTS
The study analysis comprised 32 endometrial cancer patients. All subjects were treated with carboplatin and paclitaxel chemotherapy; currently, 186 cycles have been administered and 94% of patients have completed the planned number of cycles. Grade 3 neutropenia developed in 1 (3.1%) patient; there was no incidence of grade 4 neutropenia. Moreover, we observed grade 3 anemia in four (12.5%) patients and grade 4 anemia in one (3.1%) patient. One (3.1%) patient developed grade 3 thrombocytopenia; grade 4 thrombocytopenia was not observed. Five patients exhibited progressive disease, three of whom have since expired; mean progression free survival and follow-up were 17.4 months and 18.9 months, respectively.
CONCLUSION
The preliminary results from our study suggest that the sandwich approach to treating high risk endometrial cancer patients is feasible. Hematologic toxicity was well tolerated and non-hematologic toxicity was mild and easily managed. Further study of this novel regimen in a larger patient population with extended follow-up is necessary.

Keyword

Chemotherapy; Endometrial cancer; Gynecologic oncology; Radiotherapy

MeSH Terms

Anemia
Carboplatin
Disease-Free Survival
Endometrial Neoplasms
Female
Follow-Up Studies
Humans
Incidence
Neutropenia
Paclitaxel
Retrospective Studies
Thrombocytopenia
Carboplatin
Paclitaxel

Figure

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  Fig. 1 Progression-free survival for high-risk endometrial cancer patients treated with sequential multimodal therapy.

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