Adjuvant Concurrent Chemoradiation and Chemotherapy for High Risk Non-Metastatic Endometrial Cancer
PO-1131
Abstract
Adjuvant Concurrent Chemoradiation and Chemotherapy for High Risk Non-Metastatic Endometrial Cancer
Authors: RAJAN|, Rajasree(1)*[nidhil2000@gmail.com];Kunheri|, Dr Beena (2);Tatineni|, Dr Thushar (2);
(1)Amrita Institute of Medical Sciences, Department of Radiation Oncology, Kochi, India;(2)Amrita Institute of Medical Sciences, Department of Radiation Oncology, Kochin, India;
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Purpose or Objective
Background:
Although women with endometrial cancer generally have a favourable prognosis, those with high-risk disease features are at increased risk of recurrence. The PORTEC-3 trial was initiated to investigate the benefit of concurrent chemoradiation therapy followed by adjuvant chemotherapy for women with high-risk endometrial cancer, and found to be well tolerated and beneficial in stage III endometriod and serous histology irrespective of the stage .We have initiated a study to evaluate the tolerance and toxicity of the treatment in our patients belonging to the Asian Subset .
Aim:
To assess the toxicity and tolerance of adjuvant concurrent chemoradiation followed by chemotherapy for high risk non metastatic endometrial cancer (HREC)
Secondary endpoints are failure free survival and overall survival.
Material and Methods
25 patients were enrolled into the study so far , and 20 patients who had completed the entire course of treatment were analyzed for the acute toxicities and tolerance during CTRT and adjuvant chemotherapy from December 2016 to August 2019 .
The patients were treated with radiotherapy to a dose between 45 to 48.6Gy in 1.8Gy/fraction over 25 to 28 days, 5 days per week. Chemotherapy during radiation was two cycles of cisplatin 50mg/m2 (week 1 and week 5), followed by 4 cycles of adjuvant chemotherapy – carboplatin AUC 5 & paclitaxel 175mg/m2 .
The primary endpoint being Toxicity analysis.
Results
This is an interim analysis for acute toxicity and tolerance to CTRT and adjuvant chemotherapy.
The median age of our patients was 62yrs range (47 to 74 years). Acute Toxicity analysis showed that all the patients developed grade 1 & 2 toxicity during various stages of concurrent chemoradiation and adjuvant chemotherapy.
During CTRT the major haematological toxicity was grade II Anemia (81%).Grade I Vomiting was seen in all patients undergoing CTRT and only very few patients had grade III vomiting(<5%). It was noted that 18(90%) of the patients developed grade 1 & 2 Gastrointestinal toxicity during CTRT.The most common complaint was diarrhoea. The toxicities of CTRT resolved after completion of treatment without any persistence of acute side effects thereafter.
During adjuvant chemotherapy , grade II neutropenia(69.6%) was a significant haematological toxicity observed. Treatment limiting peripheral neuropathy was seen in 2 patients ,and hence could not take 4th cycle of adjuvant chemotherapy.All other patients completed the proposed treatment.
Conclusion
Tolerance to CTRT and adjuvant chemotherapy in our subset of patients has been good and none of the patients had unforeseen treatment breaks due to toxicity during CTRT.
This is concordant with the results of PORTEC III data of acute toxicity analysis. Long term follow up is required to assess the chronic toxicity and survival.