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Uterine papillary serous carcinoma: evaluation of multimodality treatment with abdominopelvic radiotherapy and chemotherapy
  1. H. Steed*,
  2. L. Manchul,
  3. B. Rosen*,
  4. A. Fyles,
  5. G. Lockwood,
  6. S. Laframboise*,
  7. J. Murphy*,
  8. M. Milosevic,
  9. W. Chapman§ and
  10. A M. Oza
  1. * Departments of Gynecology Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
  2. Departments of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
  3. Departments of Biostatistics, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
  4. § Departments of Pathology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
  5. Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada
  1. Address correspondence and reprint requests to: Dr Lee Manchul, MD, FRCPC, Department of Radiation Oncology, 5th Floor, 5-960 Princess Margaret Hospital, 610 University Avenue, Toronto, ON, Canada M5G 2M9. Email: lee.manchul{at}rmp.uhn.on.ca

Abstract

The aim of this study was to compare overall survival (OS), progression-free survival (PFS), and relapse patterns between different modalities of treatment for uterine papillary serous carcinoma (UPSC). A retrospective review of 124 patients with pathologically confirmed UPSC was performed, of whom, 97 patients were eligible for study. Postoperative treatment groups included adjuvant radiotherapy consisting of whole abdomen and a pelvic boost (abdominopelvic radiotherapy [APRT]) (55 patients), paclitaxel and carboplatin chemotherapy (CT) for six cycles followed by APRT (18 patients), CT only (5 patients), and 19 patients were observed without postoperative adjuvant therapy. Three-year OS was 81% and 63% for the CT followed by APRT and APRT alone, respectively (P= 0.11). After controlling for stage, the group treated with APRT alone had significantly decreased OS and PFS compared to the CT/APRT group (HR 3.6; 1.3–9.8; P= 0.01) and (HR 2.9; 95% CI 1.1–7.3; P= 0.03), respectively. Within the limitations of a retrospective study, the results of this study indicate that multimodality postoperative treatment with paclitaxel and a platinum-based CT followed by APRT may increase the survival of patients with UPSC. However, further prospective studies using these combined modalities are needed to confirm these findings.

  • multimodality therapy
  • uterine papillary serous carcinoma

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