A multi-institutional analysis of sequential versus ‘sandwich’ adjuvant chemotherapy and radiotherapy for stage IIIC endometrial carcinoma

dc.contributor.authorAkyurek, Serap
dc.contributor.departmentTıp Fakültesitr_TR
dc.date.accessioned2020-11-20T08:07:31Z
dc.date.available2020-11-20T08:07:31Z
dc.date.issued2019
dc.description.abstractObjective: To analyze the outcomes of sequential or sandwich chemotherapy (ChT) and radiotherapy (RT) in patients with node-positive endometrial cancer (EC). Methods: Data from 4 centers were collected retrospectively for 179 patients with stage IIIC EC treated with postoperative RT and ChT (paclitaxel and carboplatin). Patients were either treated with 6 cycles of ChT followed by RT (sequential arm; 96 patients) or with 3 cycles of ChT, RT, and an additional 3 cycles of ChT (sandwich arm; 83 patients). Prognostic factors affecting overall survival (OS) and progression-free survival (PFS) were analyzed. Results: The 5-year OS and PFS rates were 64% and 59%, respectively, with a median follow-up of 41 months (range, 5-167 months). The 5-year OS rates were significantly higher in the sandwich than sequential arms (74% vs. 56%; p=0.03) and the difference for 5-year PFS rates was nearly significant (65% vs. 54%; p=0.05). In univariate analysis, treatment strategy, age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology, rate of myometrial invasion, and grade were prognostic factors for OS and PFS. In multivariate analysis, non-endometrioid histology, advanced FIGO stage, and adjuvant sequential ChT and RT were negative predictors for OS, whereas only non-endometrioid histology was a prognostic factor for PFS. Conclusion: Postoperative adjuvant ChT and RT for stage IIIC EC patients, either given sequentially or sandwiched, offers excellent clinical efficacy and acceptably low toxicity. Our data support the superiority of the sandwich regimen compared to the sequential strategy in stage IIIC EC patients for OS.tr_TR
dc.description.indexPubmed
dc.identifier.endpage13tr_TR
dc.identifier.issue3tr_TR
dc.identifier.startpage1tr_TR
dc.identifier.urihttps://doi.org/10.3802/jgo.2019.30.e28tr_TR
dc.identifier.urihttp://hdl.handle.net/20.500.12575/72474
dc.identifier.volume30tr_TR
dc.language.isoentr_TR
dc.relation.isversionof10.3802/jgo.2019.30.e28tr_TR
dc.relation.journalJ Gynecol Oncol .tr_TR
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıtr_TR
dc.subjectChemotherapytr_TR
dc.subjectEndometrial Cancertr_TR
dc.subjectLymphatic Metastasistr_TR
dc.titleA multi-institutional analysis of sequential versus ‘sandwich’ adjuvant chemotherapy and radiotherapy for stage IIIC endometrial carcinomatr_TR
dc.typeArticletr_TR

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