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Adjuvant Chemotherapy in Endometrial Carcinoma: Overview of Randomised Trials.

Högberg, Thomas LU (2008) In Clinical Oncology 20. p.463-469
Abstract
Endometrial cancer generally has a good prognosis because most cases are diagnosed in stage I. It is possible to identify subgroups of patients with early stage endometrial cancer with a poor prognosis. Despite a traditional generous use of adjuvant radiotherapy those patients have less than an 80% 5-year overall survival. In this group there is a need for an effective systemic adjuvant therapy. Two randomised studies have shown better response rates but no significant difference in overall survival for doxorubicin-cisplatin vs doxorubicin in advanced or recurrent endometrial cancer. Mainly on the basis of the superior response rates, doxorubicin-cisplatin was for many years regarded as the standard chemotherapy in endometrial cancer.... (More)
Endometrial cancer generally has a good prognosis because most cases are diagnosed in stage I. It is possible to identify subgroups of patients with early stage endometrial cancer with a poor prognosis. Despite a traditional generous use of adjuvant radiotherapy those patients have less than an 80% 5-year overall survival. In this group there is a need for an effective systemic adjuvant therapy. Two randomised studies have shown better response rates but no significant difference in overall survival for doxorubicin-cisplatin vs doxorubicin in advanced or recurrent endometrial cancer. Mainly on the basis of the superior response rates, doxorubicin-cisplatin was for many years regarded as the standard chemotherapy in endometrial cancer. GOG-177 was the first phase III study on chemotherapy in advanced or recurrent endometrial cancer that showed a survival advantage. Paclitaxel-doxorubicin-cisplatin was better than doxorubicin-cisplatin, but the toxicity of the three-drug regimen has precluded general acceptance. Paclitaxel-carboplatin has rendered high response rates in endometrial cancer and is widely used, despite the lack of evidence based on randomised studies. GOG-122 was a pivotal randomised study that compared doxorubicin-cisplatin with whole abdominal radiotherapy in advanced optimally operated endometrial cancer and showed that chemotherapy with doxorubicin-cisplatin resulted in superior survival. Two recent studies have compared adjuvant chemotherapy (cyclophosphamide-doxorubicin-cisplatin) with adjuvant radiotherapy in early stage endometrial cancer. Both studies failed to show a difference between the treatments, but neither was powered to show non-inferiority. Another study (NSGO-EC-9501/EORTC-55991) compared adjuvant radiotherapy plus chemotherapy with adjuvant radiotherapy and showed better survival with the combination. The implications of these studies are discussed. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Oncology
volume
20
pages
463 - 469
publisher
Elsevier
external identifiers
  • wos:000258055200010
  • pmid:18467080
  • scopus:46149123209
ISSN
1433-2981
DOI
10.1016/j.clon.2008.04.001
language
English
LU publication?
yes
id
04dd3dc6-be8a-43fb-bfde-5db7e02efc34 (old id 1154359)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18467080?dopt=Abstract
date added to LUP
2008-06-03 10:55:50
date last changed
2017-11-05 04:44:25
@article{04dd3dc6-be8a-43fb-bfde-5db7e02efc34,
  abstract     = {Endometrial cancer generally has a good prognosis because most cases are diagnosed in stage I. It is possible to identify subgroups of patients with early stage endometrial cancer with a poor prognosis. Despite a traditional generous use of adjuvant radiotherapy those patients have less than an 80% 5-year overall survival. In this group there is a need for an effective systemic adjuvant therapy. Two randomised studies have shown better response rates but no significant difference in overall survival for doxorubicin-cisplatin vs doxorubicin in advanced or recurrent endometrial cancer. Mainly on the basis of the superior response rates, doxorubicin-cisplatin was for many years regarded as the standard chemotherapy in endometrial cancer. GOG-177 was the first phase III study on chemotherapy in advanced or recurrent endometrial cancer that showed a survival advantage. Paclitaxel-doxorubicin-cisplatin was better than doxorubicin-cisplatin, but the toxicity of the three-drug regimen has precluded general acceptance. Paclitaxel-carboplatin has rendered high response rates in endometrial cancer and is widely used, despite the lack of evidence based on randomised studies. GOG-122 was a pivotal randomised study that compared doxorubicin-cisplatin with whole abdominal radiotherapy in advanced optimally operated endometrial cancer and showed that chemotherapy with doxorubicin-cisplatin resulted in superior survival. Two recent studies have compared adjuvant chemotherapy (cyclophosphamide-doxorubicin-cisplatin) with adjuvant radiotherapy in early stage endometrial cancer. Both studies failed to show a difference between the treatments, but neither was powered to show non-inferiority. Another study (NSGO-EC-9501/EORTC-55991) compared adjuvant radiotherapy plus chemotherapy with adjuvant radiotherapy and showed better survival with the combination. The implications of these studies are discussed.},
  author       = {Högberg, Thomas},
  issn         = {1433-2981},
  language     = {eng},
  pages        = {463--469},
  publisher    = {Elsevier},
  series       = {Clinical Oncology},
  title        = {Adjuvant Chemotherapy in Endometrial Carcinoma: Overview of Randomised Trials.},
  url          = {http://dx.doi.org/10.1016/j.clon.2008.04.001},
  volume       = {20},
  year         = {2008},
}