A prospective phase II study of chemoradiation followed by adjuvant chemotherapy for FIGO stage I-IIIA (1988) uterine papillary serous carcinoma of the endometrium

Anuja Jhingran, Lois M. Ramondetta, Diane C. Bodurka, Brian Slomovitz, Jubilee Brown, Lawrence B. Levy, Michael E. Garcia, Patricia J. Eifel, Karen H. Lu, Thomas W. Burke

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective: To prospectively evaluate tumor control, survival, and toxic effects in patients with International Federation of Gynecology and Obstetrics (1988) stage I-IIIA papillary serous carcinoma of the endometrium treated with concurrent chemoradiation and adjuvant chemotherapy. Methods: Thirty-two patients were enrolled from October 2001 through July 2009. Patients underwent full surgical disease staging and postoperative concurrent weekly paclitaxel (50 mg/m2) and pelvic RT to 45 Gy plus a vaginal cuff boost followed by 4 cycles of adjuvant paclitaxel (135 mg/m2). Results: Thirty patients (94%) were evaluable (3 with stage IA disease, 11 IB, 3 IC, 1 IIB, and 12 IIIA). Eighteen patients (60%) received all 5 planned courses of concurrent chemotherapy, 10 (33%) received 4 courses, and 2 (7%) received 3 courses. All 30 patients received RT; 27 (90%) received the full dose, 2 received 43.2 Gy, and 1 received 39.6 Gy owing to toxic effects. Twenty-three patients (77%) completed all 4 cycles of adjuvant paclitaxel, 3 (10%) completed 3 cycles, 2 (7%) completed 2 cycles, and 2 received no adjuvant therapy. Overall survival (OS), progression-free survival (PFS), and local control rates for all patients were 93%, 87%, and 87%, respectively, at 2 years and 85%, 83%, and 87%, respectively, at 5 years. Six patients developed (20%) grade 3/4 toxicities from the treatment. Four patients (13%) had grade 3 or more severe bowel complications and two patients developed symptomatic pelvic fractures. Conclusions: Treatment with concurrent paclitaxel and pelvic RT followed by 4 courses of systemic paclitaxel produced favorable results in patients with surgically staged I-III UPSC.

Original languageEnglish (US)
Pages (from-to)304-309
Number of pages6
JournalGynecologic Oncology
Volume129
Issue number2
DOIs
StatePublished - May 2013
Externally publishedYes

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Papillary Carcinoma
Adjuvant Chemotherapy
Endometrial Neoplasms
Paclitaxel
Poisons
Survival
Gynecology
Obstetrics
Disease-Free Survival
Therapeutics

Keywords

  • Chemotherapy
  • Concurrent chemotherapy
  • Endometrial carcinoma
  • Papillary serous
  • Radiation therapy
  • Radiotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

A prospective phase II study of chemoradiation followed by adjuvant chemotherapy for FIGO stage I-IIIA (1988) uterine papillary serous carcinoma of the endometrium. / Jhingran, Anuja; Ramondetta, Lois M.; Bodurka, Diane C.; Slomovitz, Brian; Brown, Jubilee; Levy, Lawrence B.; Garcia, Michael E.; Eifel, Patricia J.; Lu, Karen H.; Burke, Thomas W.

In: Gynecologic Oncology, Vol. 129, No. 2, 05.2013, p. 304-309.

Research output: Contribution to journalArticle

Jhingran, Anuja ; Ramondetta, Lois M. ; Bodurka, Diane C. ; Slomovitz, Brian ; Brown, Jubilee ; Levy, Lawrence B. ; Garcia, Michael E. ; Eifel, Patricia J. ; Lu, Karen H. ; Burke, Thomas W. / A prospective phase II study of chemoradiation followed by adjuvant chemotherapy for FIGO stage I-IIIA (1988) uterine papillary serous carcinoma of the endometrium. In: Gynecologic Oncology. 2013 ; Vol. 129, No. 2. pp. 304-309.
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abstract = "Objective: To prospectively evaluate tumor control, survival, and toxic effects in patients with International Federation of Gynecology and Obstetrics (1988) stage I-IIIA papillary serous carcinoma of the endometrium treated with concurrent chemoradiation and adjuvant chemotherapy. Methods: Thirty-two patients were enrolled from October 2001 through July 2009. Patients underwent full surgical disease staging and postoperative concurrent weekly paclitaxel (50 mg/m2) and pelvic RT to 45 Gy plus a vaginal cuff boost followed by 4 cycles of adjuvant paclitaxel (135 mg/m2). Results: Thirty patients (94{\%}) were evaluable (3 with stage IA disease, 11 IB, 3 IC, 1 IIB, and 12 IIIA). Eighteen patients (60{\%}) received all 5 planned courses of concurrent chemotherapy, 10 (33{\%}) received 4 courses, and 2 (7{\%}) received 3 courses. All 30 patients received RT; 27 (90{\%}) received the full dose, 2 received 43.2 Gy, and 1 received 39.6 Gy owing to toxic effects. Twenty-three patients (77{\%}) completed all 4 cycles of adjuvant paclitaxel, 3 (10{\%}) completed 3 cycles, 2 (7{\%}) completed 2 cycles, and 2 received no adjuvant therapy. Overall survival (OS), progression-free survival (PFS), and local control rates for all patients were 93{\%}, 87{\%}, and 87{\%}, respectively, at 2 years and 85{\%}, 83{\%}, and 87{\%}, respectively, at 5 years. Six patients developed (20{\%}) grade 3/4 toxicities from the treatment. Four patients (13{\%}) had grade 3 or more severe bowel complications and two patients developed symptomatic pelvic fractures. Conclusions: Treatment with concurrent paclitaxel and pelvic RT followed by 4 courses of systemic paclitaxel produced favorable results in patients with surgically staged I-III UPSC.",
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AU - Ramondetta, Lois M.

AU - Bodurka, Diane C.

AU - Slomovitz, Brian

AU - Brown, Jubilee

AU - Levy, Lawrence B.

AU - Garcia, Michael E.

AU - Eifel, Patricia J.

AU - Lu, Karen H.

AU - Burke, Thomas W.

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AB - Objective: To prospectively evaluate tumor control, survival, and toxic effects in patients with International Federation of Gynecology and Obstetrics (1988) stage I-IIIA papillary serous carcinoma of the endometrium treated with concurrent chemoradiation and adjuvant chemotherapy. Methods: Thirty-two patients were enrolled from October 2001 through July 2009. Patients underwent full surgical disease staging and postoperative concurrent weekly paclitaxel (50 mg/m2) and pelvic RT to 45 Gy plus a vaginal cuff boost followed by 4 cycles of adjuvant paclitaxel (135 mg/m2). Results: Thirty patients (94%) were evaluable (3 with stage IA disease, 11 IB, 3 IC, 1 IIB, and 12 IIIA). Eighteen patients (60%) received all 5 planned courses of concurrent chemotherapy, 10 (33%) received 4 courses, and 2 (7%) received 3 courses. All 30 patients received RT; 27 (90%) received the full dose, 2 received 43.2 Gy, and 1 received 39.6 Gy owing to toxic effects. Twenty-three patients (77%) completed all 4 cycles of adjuvant paclitaxel, 3 (10%) completed 3 cycles, 2 (7%) completed 2 cycles, and 2 received no adjuvant therapy. Overall survival (OS), progression-free survival (PFS), and local control rates for all patients were 93%, 87%, and 87%, respectively, at 2 years and 85%, 83%, and 87%, respectively, at 5 years. Six patients developed (20%) grade 3/4 toxicities from the treatment. Four patients (13%) had grade 3 or more severe bowel complications and two patients developed symptomatic pelvic fractures. Conclusions: Treatment with concurrent paclitaxel and pelvic RT followed by 4 courses of systemic paclitaxel produced favorable results in patients with surgically staged I-III UPSC.

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KW - Papillary serous

KW - Radiation therapy

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