Distant recurrence more common with chemoradiation versus chemotherapy in stage III, IVA disease
WEDNESDAY, June 12, 2019 (HealthDay News) — For patients with stage III or IVA endometrial cancer, chemotherapy plus radiation is not associated with improved relapse-free survival versus chemotherapy alone, according to a study published in the June 13 issue of the New England Journal of Medicine.
Daniela Matei, M.D., from Northwestern University in Chicago, and colleagues randomly assigned 707 patients with stage III or IVA endometrial carcinoma to six months of platinum-based chemotherapy plus radiation therapy (chemoradiotherapy; 346 patients) or six cycles of combination chemotherapy alone (361 patients). Patients were followed for a median of 47 months for the primary end point of relapse-free survival.
The researchers found that the Kaplan-Meier estimate of the percentage of patients alive and relapse-free was 59 and 58 percent in the chemoradiotherapy and chemotherapy-alone groups, respectively (hazard ratio [HR], 0.90; 95 percent confidence interval [CI], 0.74 to 1.10). Compared with chemotherapy alone, chemoradiotherapy correlated with a lower five-year incidence of vaginal recurrence (2 versus 7 percent; HR, 0.36; 95 percent CI, 0.16 to 0.82) and pelvic and paraaortic lymph-node recurrence (11 versus 20 percent; HR, 0.43; 95 percent CI, 0.28 to 0.66), while distant recurrence was more common with chemoradiotherapy (27 versus 21 percent; HR, 1.36; 95 percent CI, 1.00 to 1.86).
“Our results indicate the combined regimen of radiation and chemotherapy did not result in an improvement in recurrence-free survival, and that chemotherapy alone remains the standard of care for stage III uterine cancer,” Matei said in a statement.
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