A phase II evaluation of docetaxel and carboplatin followed by tumor volume directed pelvic plus or minus paraaortic irradiation for stage III endometrial cancer

ObjectiveTo determine the feasibility and efficacy of administering docetaxel and carboplatin chemotherapy followed by tumor directed radiation in patients with advance stage endometrial cancer.MethodsPatients with surgical stage III or IV (confined to the pelvis) endometrial cancer were eligible. Treatment consisted of six cycles of docetaxel (75 mg/m2) and carboplatin (AUC 6) followed by irradiation to the involved field (50.4 Gy pelvis ± 43.5 Gy paraaortic) ± brachytherapy. Kaplan–Meier (KM) methods estimated overall survival (OS) and progression free survival (PFS).ResultsForty-five patients were enrolled, 34 (76.0%) completed the prescribed therapy. Median age 63.5 (35–85 years). Stage IIIA 8 (17.8%), IIIB 1 (2.2%) and IIIC 36 (80.0%). 39/45 (86.7%) had endometroid histology. Serious grade 4 toxicities included 14 non-hematologic and 2 hematologic. Sixteen patients died following treatment, 6 from recurrent progressive cancer, with a median follow-up of 35.6 months (0.4–74.8). KM estimates and standard error (SE) for OS at 1 year were 84.5%, (5.4%), at 3 years, 65.8%, (7.2%) and at 5 years, 56.7%, (7.9%). Median overall survival was 74.5 months. Fourteen patients recurred with KM estimates and standard error (SE) for PFS at 1 year 77.8%, (6.2%) and 3 year 54.4%, (6.7%). Median progression free survival was 36.9 months.ConclusionsDocetaxel and carboplatin followed by tumor directed irradiation for advanced stage endometrial cancer has acceptable toxicity and efficacy that allows for this regimen to be considered a viable treatment option for these patients.

► The combination of doctaxel and carboplatin followed by tumor directed irradiation has acceptable toxicity.
► The combination of docetaxel and carboplatin followed by tumor directed irradiation is efficacious.
► The results of this phase II trial warrants further evaluation of this regimen in a randomized phase 3 trial.