A phase II evaluation of docetaxel and carboplatin followed by tumor volume directed pelvic plus or minus paraaortic irradiation for stage III endometrial cancer

Gynecol Oncol. 2012 May;125(2):388-93. doi: 10.1016/j.ygyno.2012.02.003. Epub 2012 Feb 10.

Abstract

Objective: To determine the feasibility and efficacy of administering docetaxel and carboplatin chemotherapy followed by tumor directed radiation in patients with advance stage endometrial cancer.

Methods: Patients with surgical stage III or IV (confined to the pelvis) endometrial cancer were eligible. Treatment consisted of six cycles of docetaxel (75 mg/m(2)) and carboplatin (AUC 6) followed by irradiation to the involved field (50.4 Gy pelvis ± 43.5 Gy paraaortic)±brachytherapy. Kaplan-Meier (KM) methods estimated overall survival (OS) and progression free survival (PFS).

Results: Forty-five patients were enrolled, 34 (76.0%) completed the prescribed therapy. Median age 63.5 (35-85 years). Stage IIIA 8 (17.8%), IIIB 1 (2.2%) and IIIC 36 (80.0%). 39/45 (86.7%) had endometroid histology. Serious grade 4 toxicities included 14 non-hematologic and 2 hematologic. Sixteen patients died following treatment, 6 from recurrent progressive cancer, with a median follow-up of 35.6 months (0.4-74.8). KM estimates and standard error (SE) for OS at 1 year were 84.5%, (5.4%), at 3 years, 65.8%, (7.2%) and at 5 years, 56.7%, (7.9%). Median overall survival was 74.5 months. Fourteen patients recurred with KM estimates and standard error (SE) for PFS at 1 year 77.8%, (6.2%) and 3 year 54.4%, (6.7%). Median progression free survival was 36.9 months.

Conclusions: Docetaxel and carboplatin followed by tumor directed irradiation for advanced stage endometrial cancer has acceptable toxicity and efficacy that allows for this regimen to be considered a viable treatment option for these patients.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage
  • Carboplatin / adverse effects
  • Combined Modality Therapy / adverse effects
  • Disease-Free Survival
  • Docetaxel
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / pathology
  • Endometrial Neoplasms / radiotherapy*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Prospective Studies
  • Survival Rate
  • Taxoids / administration & dosage
  • Taxoids / adverse effects

Substances

  • Taxoids
  • Docetaxel
  • Carboplatin