- In patients with stage IIIC endometrial carcinoma, use of chemotherapy before external beam radiation therapy (EBRT) has increased, while the use of radiotherapy before chemotherapy decreased.
- Chemotherapy before radiotherapy improves survival vs concurrent therapy.
- Survival is similar with chemotherapy-radiotherapy vs radiotherapy-chemotherapy sequence.
Why this matters
- Optimal sequence of chemoradiation is controversial in these patients; in PORTEC-3 trial, radiotherapy-chemotherapy sequence improved PFS but failed to show OS benefit.
- Prospective validation is needed.
- 6981 patients with stage IIIC endometrial carcinoma treated with adjuvant chemoradiation.
- Funding: None disclosed.
- Median follow-up of the cohort was 43 months.
- During 2004-2015, the use of chemotherapy before radiotherapy increased from 39.9% to 75.5%, while radiotherapy before chemotherapy decreased from 34.0% to 4.4% (P<.001>
- Compared with chemotherapy-radiotherapy sequence, risk for mortality was:
- higher with concurrent therapy (HR, 1.47; 95% CI, 1.31-1.66).
- not significantly different with radiotherapy-chemotherapy sequence (HR, 1.01; 95% CI, 0.86-1.19).
- Mortality was 25% higher (HR, 1.25; 95% CI, 1.13-1.39) in patients who received radiotherapy first (radiotherapy-chemotherapy sequence or concurrent treatment) vs chemotherapy-radiotherapy sequence.
- Retrospective study.