Abstract 800P
Background
Chemotherapy plus external beam radiotherapy (EBRT) is the current standard adjuvant therapy for patients (pts) with high-risk stage I-III endometrial cancer (EC). Despite this, the best combination schedule for chemoradiation (CR) has not been defined yet. We aimed at describing the clinical outcomes of pts with EC receiving platinum-based chemotherapy administered 2-3 cycles before and after radiotherapy as adjuvant treatment (‘sandwich’ chemoradiation, SCR).
Methods
We retrospectively analyzed a cohort of 83 consecutive pts with high-risk EC treated with adjuvant CR between January 2006 and December 2020 at the National Cancer Institute of Aviano, Italy. The association between clinico-pathological and treatment (i.e. CR scheme) characteristics with outcomes (i.e. disease-free survival (DFS) and overall survival (OS)) was tested through Cox regression analysis.
Results
Median age at diagnosis was 65 [55;71] years. Pelvic lymphadenectomy was performed in 68 (82%) pts, lomboaortic lymphadenectomy in 23 (29%). Overall, 43 (52%) pts had an endometrioid histology, 51 (62%) a high grade tumor, 30 (40%) positive lymph nodes, 52 (74%) lymphovascular space invasion, 5 (7%) positive peritoneal washing. According to FIGO classification, stage was I for 26 (31%) pts, II for 13 (16%) pts and III for 44 (53%) pts. A total of 66 (80%) pts received SCR while the others received different chemoradiation schedules. Radiotherapy was administered as EBRT (84%), brachitherapy (5%) or both (11%); 81% of pts received concomitant chemotherapy. A platinum-based combination was used in 43 (52%) pts. Median follow-up was 43.5 months. At 36 months, 72% of pts were free from relapse and 82% were alive. SCR (HR 0.33, CI 0.14-0.79, p=0.013) and FIGO stage (HR 1.82, CI 1.07-3.08, p=0.026) retained their independent association with DFS after correction for patients’ age, tumor histology and grading. Age was the only prognostic factor for OS (HR 1.07, CI 1.00-1.14, p=0.047). Only 7 (8%) pts suffered from grade 2 toxicities, 5 treated with SCR.
Conclusions
‘Sandwich’ chemoradiation is a reasonable adjuvant treatment option in pts with high-risk EC. Prospective studies are needed to support these preliminary findings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
L. Gerratana: Non-Financial Interests, Personal, Other: Menarini Silicon Biosystems; Financial Interests, Personal, Other, fee: Lilly. F. Puglisi: Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Personal and Institutional, Research Grant, and fee: Roche; Financial Interests, Personal and Institutional, Other: Eli Lilly; Financial Interests, Personal, Other, fee: Amgen; Financial Interests, Personal, Other, fee: Ipsen; Financial Interests, Personal, Other, fee: Merck Sharp & Dohme (MSD); Financial Interests, Personal, Other, fee: Takeda; Financial Interests, Personal, Other, fee: Eisai; Financial Interests, Personal, Other, fee: Novartis ; Financial Interests, Personal, Other, fee: Pfizer. All other authors have declared no conflicts of interest.