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EV150/#1087  Adjuvant chemotherapy followed by radiation therapy in high-risk endometrial cancer: a real world experience in a tertiary cancer centre in South India
  1. Thomas Samuel Ram1,
  2. B Swathi2,
  3. Arvind Sathyamurthy2,
  4. Jeba Reddy2,
  5. Neenu John2,
  6. Vinotha Thomas3,
  7. Anuradha Chandramohan4,
  8. Ashish Singh5 and
  9. Anitha Thomas6
  1. 1Christian Medical College, Ida B Scudder Cancer Centreradiation Oncology, Vellore, Tamil Nadu, India
  2. 2Christian Medical College, Ida B Scudder Cancer Centre, Radiation Oncology, Vellore, Tamil Nadu, India
  3. 3Christian Medical College, Vellore, Tamil Nadu, India, Gynaecologic Oncology, Vellore, Tamil Nadu, India
  4. 4Christian Medical College, Radiodiagnosis, Vellore, Tamil Nadu, India
  5. 5Christian Medical College Vellore, Department of Medical Oncology, Ranipet, India
  6. 6Christian Medical College, Gynaecologic Oncology, Vellore, Tamil Nadu, India

Abstract

Introduction Endometrial cancer (EC) is on the rise in developing countries like India. These cancers, which have high-risk factors, carry an increasing risk of recurrence and metastasis. This study investigates the impact of adjuvant therapy on survival in high-risk EC patients.

Methods A retrospective analysis of 97 high-risk EC patients treated (2011-2018) at our institute with follow-up until May 2022 was conducted. Patients underwent surgery and adjuvant therapy (chemoradiation, radiotherapy, chemotherapy, or none). We compared survival and toxicity based on cancer type (endometrioid vs. non-endometrioid) and treatment received.

Results The mean age of the patients in this study was 57.5 years (range 36-81 years). Endometrioid carcinoma and non-endometrioid carcinoma accounted for 76.3% and 23.6%, respectively. Type of surgery, clear margins, perineural invasion, adjuvant treatment received, RT (EBRT & VBT) were statistically significant (p <0.05). Most of the patients were FIGO stage III disease (32.9%). Chemotherapy followed by radiotherapy was given in 63.9% of patients, radiotherapy alone (15.5%), chemotherapy (10.3%), no adjuvant therapy (9.3%) and only hormonal therapy (1%). Post-operative adjuvant treatment showed significant improvement in Disease-free survival(DFS) (p=0.002) & Overall survival (OS) (p=0.013). Median OS was 61 months (95% CI 36.8 -85.2), and Median DFS was 43 months (95% CI 15 - 71).

Conclusion/Implications Sequential chemotherapy followed by radiotherapy is as tolerable as radiotherapy alone for high-risk early-stage endometrial cancer. The efficacy of this sequence needs to be studied further compared with the PORTEC-3 protocol of chemoradiotherapy followed by chemotherapy in high-risk endometrial cancer

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