- In patients with high-risk endometrial cancer (HREC), chemoradiotherapy (CRT; adjuvant chemotherapy during and after radiotherapy) extends OS and failure-free survival (FFS) vs pelvic radiotherapy alone.
- Survival benefit was significant in patients with stage III or serous cancers.
Why this matters
- CRT can become a new standard of care, especially for women with stage III endometrial cancer or serous cancers, or both.
- Post hoc analysis of phase 3 PORTEC-3 trial of 660 women with HREC, randomly assigned to receive radiotherapy or CRT (2 cycles of cisplatin during RT, followed by 4 cycles of carboplatin-paclitaxel).
- Funding: Dutch Cancer Society.
- Median follow-up, 72.6 months.
- At 5 years, CRT vs radiotherapy alone significantly improved:
- OS (81.4% vs 76.1%; aHR, 0.70; P=.034);
- FFS (76.5% vs 69.1%; aHR, 0.70; P=.016).
- CRT significantly improved survival in:
- stage III cancer: OS (aHR, 0.63; P=.043) and FFS (aHR, 0.61; P=.011);
- serous cancer: OS (aHR, 0.48; P=.037) and FFS (aHR, 0.42; P=.008).
- Distant metastases were more frequent with radiotherapy (HR, 0.74; P=.047).
- Grade ≥3 adverse event (AE) rates were similar between groups.
- Grade ≥2 AEs were more common in the CRT group (38% vs 23%; P=.002).
- Grade ≥2 sensory neuropathy was more frequent with CRT (6% vs 0%).
- Open-label design.