© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Posted online December 5, 2005 on www.jco.org
A new study shows for the first time that giving a combination of two chemotherapy drugs after surgery to women with advanced endometrial cancer reduces the risk of their cancer returning and helps them live longer than if they receive radiation therapy to the entire abdomen. The study was published in the Journal of Clinical Oncology.
Funded by the National Cancer Institute, the study was conducted by the Gynecologic Oncology Group (GOG), a group of researchers from medical centers around the country that conducts research on cancers of the reproductive organs, such as those of the ovaries, uterus, and cervix.
Endometrial cancer - cancer of the uterus - 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. About 15% to 20% of patients diagnosed with endometrial cancer have advanced disease.
In this study, researchers compared the rate of recurrence and overall survival between 194 women with advanced endometrial cancer who received the chemotherapy drugs doxorubicin and cisplatin and 202 women who received radiation therapy to the entire abdomen. After five years, 50% of patients who received chemotherapy were estimated to be free of disease compared with 38% of those who received radiation. Moreover, 55% of patients who received chemotherapy were estimated to be alive after five years, compared with 42% of patients in the radiation group.
However, serious side effects were more common in the chemotherapy group. The most common serious side effects included reduced blood cell counts (which increase the risk of bleeding, infection, and fatigue) and problems with the digestive and nervous systems, liver, and heart. Deaths due to treatment were twice as common in the chemotherapy group (4%, vs. 2% of radiation patients).
Another GOG study is underway to see if the chemotherapy drugs carboplatin and paclitaxel will be as effective, but with fewer serious side effects. A treatment with fewer side effects could help more patients with advanced endometrial cancer, many of whom are elderly or have other illnesses (such as heart disease, high blood pressure, and diabetes) that might prohibit the use of aggressive chemotherapy.
In addition, another GOG study evaluated the use of combination chemotherapy following "involved field" radiation therapy (radiation to only part of the abodomen) for advanced endometrial cancer to see if patients treated with this regimen fare better than those who receive either treatment alone. Results from this study are not yet available.In the future, doctors may decide to use a combination of therapies to treat women with advanced endometrial cancer.
What Does This Mean For Patients?
This is a very exciting advance that could help many women live longer, and reduce the chance their disease will return. Women diagnosed with advanced endometrial cancer should talk with their oncologists about available treatment options. While intensive chemotherapy can be very effective, it also has risks - such as serious side effects - that will need to be weighed by the patient and her doctor.