Hypothesis We hypothesize that adjuvant radiation and chemotherapy improve the clinical benefit from treatment of advanced-stage endometrial adenocarcinoma.

Methods We conducted a retrospective review of 125 patient with stage III or IVA endometrial adenocarcinoma who received adjuvant chemotherapy (n = 60) or chemoradiation (n = 65). Primary end points were rate of clinical benefit (ie, the percentage of patients who were alive and disease-free for at least 6 months after the last day of adjuvant treatment) and progression-free and overall survival.

Results The addition of radiation to chemotherapy improved the rate of clinical benefit from 55% to 77%. Differences in clinical benefit were attributed to a reduction in the number of pelvic relapses after chemoradiation. There were no substantial differences in the rate of extrapelvic relapse events seen between the chemotherapy alone and chemoradiation groups. Patients receiving radiation had prolonged median progression-free survival (36 vs 17 months in chemotherapy alone) and median overall survival (70 vs 64 months in chemotherapy alone).

Conclusions The addition of radiation to chemotherapy improved the clinical benefit of patients with stage III or IVA endometrial adenocarcinoma. A clinical trial powered to evaluate clinical benefit and survival outcomes of chemotherapy and radiation is under way.