Adjuvant chemotherapy and radiation therapy with the “sandwich” method for endometrial cancer: an institutional analysis

Abstract

Introduction. Choice of adjuvant therapy for high risk endometrial cancers is controversial. The so-called “sandwich”\xa0regimen of pelvic external beam radiation administered between cycles of Carboplatin/Paclitaxel (CT-RT-CT)\xa0is commonly used in clinical practice but has not been evaluated in randomized endometrial cancer trials. There\xa0is relatively little published data regarding toxicity, patient tolerance, and efficacy of this regimen. Here, we report\xa0our institutional experience of CT-RT-CT for locally advanced endometrial cancer, focusing on toxicity and rates\xa0of compliance with study therapy.\xa0 Material and methods. Medical records of consecutive patients treated for surgically staged endometrial\xa0cancer at a tertiary care academic medical center between 2010 and 2017 were reviewed. All patients received\xa0adjuvant CT-RT-CT. Progression-free and overall survival were recorded from the date of surgery. Toxicity data\xa0was obtained from patient medical records and graded according to Common Terminology for Adverse Events\xa0Criteria, version 3.0.\xa0 Results. Thirty-eight patients with histologically proven stage I–IV endometrial cancer were included. Eighty-four\xa0percent of patients were able to complete all 6 planned cycles of chemotherapy and 92% completed at least\xa04 cycles. Cumulative incidence of grade 3–4 hematologic toxicity was 55%. Locoregional recurrence was the first\xa0site of failure in 2 patients (5.1%) while distant failure was the first site of recurrence in 8 patients (21%). Two year\xa0overall survival and progression-free survival were 76% and 77% respectively.\xa0 Conclusion. Our results suggest that adjuvant chemotherapy and radiation therapy with the “sandwich” regimen\xa0is associated with acceptable toxicity and satisfactory rates of completion of planned therapy.