Radiation Therapy With or Without Cisplatin for Local Recurrences of Endometrial Cancer: Results From an NRG Oncology/GOG Prospective Randomized Multicenter Clinical Trial

Authors

Ann H Klopp
Danielle Enserro
Matthew Powell
Marcus Randall
Julian C Schink
Robert S Mannel
Laura Holman
David Bender
Christina L Kushnir
Floor Backes
Susan L Zweizig
Steven Waggoner
Kristin A Bradley
Lana DeSouza Lawrence
Parviz Hanjani
Christopher J Darus
William Small
Higinia R Cardenes
Jonathan M Feddock
David S Miller

Publication Date

7-10-2024

Journal

Journal of Clinical Oncology

DOI

10.1200/JCO.23.01279

PMID

38662968

PMCID

PMC11681946

PubMedCentral® Posted Date

7-10-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Purpose: Pelvic recurrence is a frequent pattern of relapse for women with endometrial cancer. A randomized trial compared progression-free survival (PFS) after treatment with radiation therapy alone as compared with concurrent chemotherapy.

Materials and methods: Between February 2008 and August 2020, 165 patients were randomly assigned 1:1 to receive either radiation treatment alone or a combination of chemotherapy and radiation treatment. The primary objective of this study was to determine whether chemoradiation therapy was more effective than radiation therapy alone at improving PFS.

Results: The majority of patients had low-grade (1 or 2) endometrioid histology (82%) and recurrences confined to the vagina (86%). External beam with either the three-dimensional or intensity modulated radiation treatment technique was followed by a boost delivered with brachytherapy or external beam. Patients randomly assigned to receive chemotherapy were treated with once weekly cisplatin (40 mg/m2). Rates of acute toxicity were higher in patients treated with chemoradiation as compared with radiation treatment alone. Median PFS was longer for patients treated with radiation therapy alone as compared with chemotherapy and radiation (median PFS was not reached for RT v 73 months for chemoradiation, hazard ratio of 1.25 (95% CI, 0.75 to 2.07). At 3 years, 73% of patients treated definitively with radiation and 62% of patients treated with chemoradiation were alive and free of disease progression.

Conclusion: Excellent outcomes can be achieved for women with localized recurrences of endometrial cancer when treated with radiation therapy. The addition of chemotherapy does not improve PFS for patients treated with definitive radiation therapy for recurrent endometrial cancer and increases acute toxicity. Patients with low-grade and vaginal recurrences who constituted the majority of those enrolled are best treated with radiation therapy alone.

Keywords

Humans, Female, Endometrial Neoplasms, Cisplatin, Middle Aged, Neoplasm Recurrence, Local, Aged, Prospective Studies, Chemoradiotherapy, Progression-Free Survival, Adult, Brachytherapy, Antineoplastic Agents

Published Open-Access

yes

Recommended Citation

Klopp, Ann H; Enserro, Danielle; Powell, Matthew; et al., "Radiation Therapy With or Without Cisplatin for Local Recurrences of Endometrial Cancer: Results From an NRG Oncology/GOG Prospective Randomized Multicenter Clinical Trial" (2024). Faculty, Staff and Student Publications. 4594.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/4594