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LiFE re

Literature for ENYGO

Medical (chemo and radiotherapy) treatment of primary uterine cancer

Editor David Lindquist observed in survival outcomes compared with radiotherapy alone
[4]. Half of the relapses in patients with stage IIIC1 were in the pa-
Descriptive summary ra-aortic lymph nodes, whereas the majority of relapses in patients
with stage IIIC2 disease were distant metastasis. The authors of
Two large registry-based studies [1,3] investigated the frequency of another retrospective study on 51 patients concluded that FIGO IB
adjuvant treatment in uterine serous carcinoma (USC) and uterine uterine cancer with high-risk histology showed benefit from adjuvant
carcinosarcoma. The authors included more than 10,000 women, radiotherapy [5].
and concluded that the use of chemotherapy has increased in both
groups. A parallel increase in survival was noted and a relation with A series of 50 consecutive patients who were given SIB-VMAT
the increased use of adjuvant treatment is possible but cannot be adjuvant radiotherapy instead of vaginal brachytherapy combined
established in such studies. The possible effect of adjuvant treat- with external beam radiotherapy showed that the side effects were
ment in uterine carcinosarcoma was also investigated in a retrospec- not severe and that it could be an interesting alternative to standard
tive multi-institutional study including 300 patients [2]. This study treatment [6]. However, this needs to be assessed in a randomised
also reported an increased use of adjuvant treatment over time and controlled trial, but may present an alternative for patients who
an increased survival in patients receiving treatment compared to are not suitable for brachytherapy. Finally, one study including 208
the observation group. There are no recent randomised clinical trials patients reported different outcomes for black women compared
evaluating the effect of adjuvant treatment for USC and uterine with white women, and this is likely something which needs to be
carcinosarcoma, but due to the aggressive nature of these diseases, considered when designing future studies [7].
adjuvant treatment is often offered and these studies provide at
least some degree of evidence for this practice.

A Korean multi-centre study investigated the possible survival ben-
efit of chemoradiotherapy in patients with endometrial carcinoma.
85 patients were included between 1990-2011 and only stage IIIC
endometrial carcinomas were assessed. No additional effect was

Relevant articles retrieved Nov 2015 - Feb 2016

No Title Authors Journal Link to abstract
Gynecol Oncol.
1 Patterns of care, predictors and outcomes of chemotherapy for uterine Rauh-Hain JA et al. Gynecol Oncol. https://www.ncbi.nlm.nih.gov/
carcinosarcoma: a National Cancer Database analysis. Gynecol Oncol. pubmed/?term=26307402
https://www.ncbi.nlm.nih.gov/
2 "A multi-institutional study of outcomes in stage I-III uterine Dickson EL et al. Gynecol Oncol. pubmed/?term=26348313
carcinosarcoma." Anticancer Res. https://www.ncbi.nlm.nih.gov/
pubmed/?term=26115977
3 A multicenter analysis of adjuvant therapy after surgery for stage IIIC Yoon MS et al. Anticancer Res.
endometrial adenocarcinoma: A Korean Radiation Oncology Group study https://www.ncbi.nlm.nih.gov/
(KROG 13-17). Gynecol Oncol. pubmed/?term=26095895
https://www.ncbi.nlm.nih.gov/
4 Adjuvant radiation therapy is associated with improved pelvic control and Ly D et al. pubmed/?term=25862871
overall survival in FIGO IB endometrial carcinoma with high grade histology.
https://www.ncbi.nlm.nih.gov/
5 "Volumetric-modulated arc therapy with vaginal cuff simultaneous integrated Alongi F et al. pubmed/?term=25862871
boost as an alternative to brachytherapy in adjuvant irradiation for
endometrial cancer: a prospective study." https://www.ncbi.nlm.nih.gov/
pubmed/?term=26024766
6 Volumetric-modulated arc therapy with vaginal cuff simultaneous integrated Alongi F et al.
boost as an alternative to brachytherapy in adjuvant irradiation for endomet-
rial cancer: a prospective study.

7 Effect of race and histology on patterns of failure in women with early stage Ozen A et al.
endometrial cancer treated with high dose rate brachytherapy.

International Journal of Gynecological Cancer, Volume 26, Supplement #1 Page 28