Chemo After Surgery Extends Life in Endometrial CA

NEW YORK (Reuters Health) - A study of women with advanced endometrial cancer has found that giving two chemotherapy drugs after surgery reduced the risk of recurrence by 29 percent and extended survival by 32 percent compared with radiation therapy.

The findings could improve the care for the 15 to 20 percent of women with endometrial cancer who have advanced disease. Endometrial cancer is the most common gynecologic cancer in the United States -- the American Cancer Society estimates that in 2005, 40,880 women will be diagnosed with the disease and 7,310 will die from the disease.

In the study investigators compared recurrence rates and overall survival between 194 women randomized to 5 months of chemotherapy with doxorubicin and cisplatin with that of 202 women randomized to about one and a half months of radiation to the abdomen. The women had stage III or IV endometrial carcinoma with residual disease after surgery.

At 5 years and adjusting for disease stage, 55 percent of chemotherapy patients were predicted to be alive compared with 42 percent of whole-abdominal irradiation patients and 50 percent and 38 percent, respectively, were predicted to be free of disease.

The results of the study are published in this week's online issue of the Journal of Clinical Oncology.

"For the first time, adjuvant chemotherapy has been shown to extend survival in patients with advanced endometrial cancer," study chief Dr. Marcus E. Randall, from East Carolina University in Greenville, North Carolina Randall said in a statement.

Dr. Gini F. Fleming from the University of Chicago notes in an editorial that the current trial represents a "major step in the therapy of women with high-risk endometrial carcinoma."

However, as Randall and colleagues point out, serious treatment-related adverse events were more common and more severe in the chemotherapy arm and treatment "probably contributed" to the deaths of eight patients (4 percent) on the chemotherapy arm and five (2 percent) on the radiation arm.

"Clearly, greater efficacy and less toxicity are needed," the researchers say. They are currently conducting a study to see if two other chemotherapy drugs -- carboplatin and paclitaxel -- will be as effective, but with fewer side effects, in women with advanced endometrial cancer.

SOURCE: Journal of Clinical Oncology, online December 5, 2005.