Introduce. In the recent years for endometrial cancer patients with favorable prognosis had achieved positive results in treatment with tendency to decrease in adjuvant activity. For high risk patients the level of regional and distant relapses is retained high ― 20-30%, even with chemoradiotherapy after surgical treatment. It’s also associated with inadequate lymphadenectomy like very important diagnostic tool. In this connection, we have studied the efficacy of modified method of chemoradiotherapy with prophylactic irradiation of paraaortic lymph nodes for II-III FIGO stage patients in our investigation.
Methods. In the retro-prospective study were included 146 patients with II-III FIGO stage endometrial cancer from the Russian Scientific Centre of Roentgenoradiology, Moscow and The Oncology Center, Orsk. All patients were had hysterectomy and bilateral salpingo-oophorectomy. Depending on the adjuvant therapy in the main group were included 71 patients (36 ― chemoradiotherapy with extended fields, 20 ― chemoradiotherapy without extended fields, 15 ― only radiotherapy) and in the control group 75 patients (21 ― chemoradiotherapy without extended fields, 54 ― only radiotherapy). In the main group chemotherapy was conducted in taxane-platinume based regimen, in the control group chemotherapy was conducted in CAP regimen.
Results. Treatment was tolerable, only hematological adverse effects were worse in main group by quantity and severity (р<0,001), but without long breaks due to the stimulation of hematopoiesis. There were not late complications III-IV grade by RTOG. The median follow-up was 30 months (range, 16-50,5 months). We registered the decreased of regional relapse rate to 1,5 times, local and distant relapse rate to 2 times in main group. There weren’t relapses in only radiotherapy subgroup of main group. 5-year relapse-free survival was 76,1% in main group, 47% ― in control (p=0,002). 5-year overall survival was 85,5 and 74,5% respectively (р=0,019).
Conclusion. Adjuvant taxane-platinum-based chemoradiotherapy with preventive irradiation of paraaortic lymph nodes improves results of treatment endometrial cancer patients II-III FIGO stage with acceptable side effects rate. This method can be recommended for further randomized prospective research.
Key words: endometrial cancer, adjuvant therapy, chemoradiotherapy.
V.A. Solodky1, Yu.M. Kreynina1, A.G. Shekhtman2, A.R. Iksanova3
1Russian Scientific Center of Roentgenoradiology, Moscow
2Orenburg State Medical University, Orenburg
3Orsk Oncology Center, Orsk
Iksanova A.R. ― Head of Radiotherapy department of the Orsk Oncology Center
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