Reevaluating Treatment for Stage III Endometrial Cancer
Data on gynecological malignancies are essential for hospital, state, and national cancer registries, enabling outcome studies that compare various treatment approaches. For stage III endometrial cancer, treatment options include radiotherapy and, more recently, chemotherapy. However, whether combining these modalities improves survival outcomes remains uncertain.
A recent phase 3 trial found that adding radiation to chemotherapy did not improve overall or recurrence-free survival in patients with locally advanced endometrial cancer compared to chemotherapy alone. In this randomized study, 813 patients with stage III or IVA endometrial cancer (median age: 60 years) were assigned to receive either chemoradiotherapy (n = 407) or chemotherapy alone (n = 406). Among them, 680 received the assigned treatment (333 in the chemoradiotherapy group and 347 in the chemotherapy group). The study population was predominantly non-Hispanic White, with 10% identifying as Black, and 97% had stage III disease.
The primary endpoint of the trial was recurrence-free survival, with overall survival also analyzed across both treatment groups. Results showed no improvement in local recurrence rates for patients receiving chemoradiotherapy compared to those receiving chemotherapy alone. Overall survival remained similar between the two groups. After a median follow-up of 112 months, the median overall survival had not been reached in either arm.
This updated analysis demonstrated that adding pelvic radiation to chemotherapy provided no benefit in recurrence-free or overall survival for patients with stage III locally advanced endometrial cancer. Additionally, no pathological or demographic factors were identified that predicted a survival advantage in the chemoradiotherapy group.
