OBJECTIVE: To evaluate the safety and survival in women treated with adjuvant pelvic radiation "sandwiched" between six cycles of paclitaxel and carboplatin chemotherapy with completely resected UPSC. METHODS: Surgically staged women with UPSC (FIGO stage 1-4) and no visible residual disease were enrolled. Treatment involved paclitaxel (175 mg/m(2)) and carboplatin (AUC=6.0-7.5) every 21 days for 3 doses, followed by radiation therapy (RT), followed by an additional 3 cycles of paclitaxel and carboplatin (AUC=5-6). Survival analysis, using Kaplan-Meier methods, was performed on patients who completed at least 3 cycles of chemotherapy and RT. RESULTS: A total of 81 patients were enrolled, of which 72 patients completed the first 3 cycles of chemotherapy followed by prescribed RT. Median age was 67 years (range: 43-82 years). 59/72 (82%) had disease confined to the uterus and 13/72 (18%) had completely resected extra-uterine disease (stage 3 and 4). 65 (83%) completed the protocol. Overall PFS and OS for combined stage 1 and 2 patients was 65.5 ± 3.6 months and 76.5 ± 4.3 months, respectively. PFS and OS for combined stage 3 and 4 patients was 25.8 ± 3.0 and 35.9 ± 5.3 months, respectively. Three-year % survival probability for stage 1 and 2 patients was 84% and for stage 3 and 4 patients was 50%. Of the 435 chemotherapy cycles administered, there were 11(2.5%) G3/G4 non-hematologic toxicities. 26(6.0%) cycles had dose reductions and 37(8.5%) had dose delays. CONCLUSIONS: Compared to prior studies of single modality adjuvant therapy, RT "sandwiched" between paclitaxel and carboplatin chemotherapy is well-tolerated and highly efficacious in women with completely resected UPSC.
OBJECTIVE: To evaluate the safety and survival in women treated with adjuvant pelvic radiation "sandwiched" between six cycles of paclitaxel and carboplatin chemotherapy with completely resected UPSC. METHODS: Surgically staged women with UPSC (FIGO stage 1-4) and no visible residual disease were enrolled. Treatment involved paclitaxel (175 mg/m(2)) and carboplatin (AUC=6.0-7.5) every 21 days for 3 doses, followed by radiation therapy (RT), followed by an additional 3 cycles of paclitaxel and carboplatin (AUC=5-6). Survival analysis, using Kaplan-Meier methods, was performed on patients who completed at least 3 cycles of chemotherapy and RT. RESULTS: A total of 81 patients were enrolled, of which 72 patients completed the first 3 cycles of chemotherapy followed by prescribed RT. Median age was 67 years (range: 43-82 years). 59/72 (82%) had disease confined to the uterus and 13/72 (18%) had completely resected extra-uterine disease (stage 3 and 4). 65 (83%) completed the protocol. Overall PFS and OS for combined stage 1 and 2 patients was 65.5 ± 3.6 months and 76.5 ± 4.3 months, respectively. PFS and OS for combined stage 3 and 4 patients was 25.8 ± 3.0 and 35.9 ± 5.3 months, respectively. Three-year % survival probability for stage 1 and 2 patients was 84% and for stage 3 and 4 patients was 50%. Of the 435 chemotherapy cycles administered, there were 11(2.5%) G3/G4 non-hematologic toxicities. 26(6.0%) cycles had dose reductions and 37(8.5%) had dose delays. CONCLUSIONS: Compared to prior studies of single modality adjuvant therapy, RT "sandwiched" between paclitaxel and carboplatin chemotherapy is well-tolerated and highly efficacious in women with completely resected UPSC.
Authors: Angeles Alvarez Secord; Laura J Havrilesky; David M O'Malley; Victoria Bae-Jump; Nicole D Fleming; Gloria Broadwater; David E Cohn; Paola A Gehrig Journal: Gynecol Oncol Date: 2009-06-26 Impact factor: 5.482
Authors: Melissa A Geller; Joseph Ivy; Kathryn E Dusenbery; Rahel Ghebre; Rachel Isaksson Vogel; Peter A Argenta Journal: Gynecol Oncol Date: 2010-04-08 Impact factor: 5.482
Authors: Melissa A Geller; Joseph J Ivy; Rahel Ghebre; Levi S Downs; Patricia L Judson; Linda F Carson; Amy L Jonson; Kathryn Dusenbery; Rachel Isaksson Vogel; Matthew P Boente; Peter A Argenta Journal: Gynecol Oncol Date: 2011-01-15 Impact factor: 5.482
Authors: Gregory Sutton; Janice H Axelrod; Brian N Bundy; Tapan Roy; Howard Homesley; Roger B Lee; Paola A Gehrig; Richard Zaino Journal: Gynecol Oncol Date: 2005-10-05 Impact factor: 5.482
Authors: Marcus E Randall; Virginia L Filiaci; Hyman Muss; Nick M Spirtos; Robert S Mannel; Jeffrey Fowler; J Tate Thigpen; Jo Ann Benda Journal: J Clin Oncol Date: 2005-12-05 Impact factor: 44.544
Authors: Krystine Lupe; David P D'Souza; Janice S Kwon; John S Radwan; Ingrid A Harle; J Alex Hammond; Mark S Carey Journal: Gynecol Oncol Date: 2009-04-29 Impact factor: 5.482
Authors: Amanda Nickles Fader; Christa Nagel; Allison E Axtell; Kristine M Zanotti; Joseph L Kelley; Kathleen N Moore; Angeles Alvarez Secord; Christine S Walsh; Warner K Huh; Paola A Gehrig; Heidi Gibbons; Peter G Rose; Laura J Havrilesky; Erin Tuller; Richard D Drake; Justin Bottsford-Miller; David M O'Malley Journal: Gynecol Oncol Date: 2009-01-01 Impact factor: 5.482
Authors: C A Hamilton; M K Cheung; K Osann; L Chen; N N Teng; T A Longacre; M A Powell; M R Hendrickson; D S Kapp; J K Chan Journal: Br J Cancer Date: 2006-03-13 Impact factor: 7.640
Authors: Mark H Einstein; Merieme Klobocista; June Y Hou; Stephen Lee; Subhakar Mutyala; Keyur Mehta; Laura L Reimers; Dennis Y-S Kuo; Gloria S Huang; Gary L Goldberg Journal: Gynecol Oncol Date: 2011-11-03 Impact factor: 5.482
Authors: Marina Frimer; Eirwen M Miller; Viswanathan Shankar; Eugenia Girda; Keyur Mehta; Harriet O Smith; Dennis Y S Kuo; Gary L Goldberg; Mark H Einstein Journal: Int J Gynecol Cancer Date: 2018-11 Impact factor: 3.437