Adjuvant Therapies in Uterine Corpus Cancer
Dr. Nicholas Reed
40 slide(s) – 00:25:17 – English – 2009-01-23
After viewing this presentation the participant will be able to discuss:
- Options for adjuvant therapy in uterine corpus cancer
- Benefits vs. harm from adjuvant radiation therapy
- The current status of vaginal brachytherapy
- Studies on chemotherapy vs. radiation therapy
- Recent data on chemoradiation vs. radiation therapy
- A proposed practical schema for treatment
In this presentation Dr. Reed talks about the types of adjuvant treatment in uterine corpus cancer, focusing on radiation therapy, chemotherapy and combined radiation and chemotherapy.
With respect to the use of adjuvant radiotherapy following surgery, there is conflicting evidence. The GOG 99 and PORTEC1 studies show improved local control in high risk patients, but no survival benefit. The SEER data however shows survival benefit in high risk IC G3 patients. The ASTEC 2 study found no benefit of EBRT, with a possible improvement in local control from vaginal brachytherapy. The Cochrane review paper (Kong et al. 2007) showed no survival benefit. Dr. Reed shows an unpublished meta-analysis by Cornes et al., illustrating how patients can be grouped according to low, high and intermediate risk, and looked at for the effect of EBRT on survival in stage 1 endometrial cancer. Although vaginal brachytherapy is simple and safe to use, its role is at this time is still unclear.
Of recent interest is the NSGO EC-9501/ EORTC-55991 study comparing radiation therapy to combined chemoradiation; the data presented by Hogberg showed an improvement in progression-free survival with chemoradiation. Dr.Reed discusses this and other chemotherapy studies, and proposes a practical schema for treatment in endometrial cancer patients.
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