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

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dc.contributor.authorOnal, Cem
dc.contributor.authorSari, Sezin Yuce
dc.contributor.authorYildirim, Bema Akkus
dc.contributor.authorYavas, Guler
dc.contributor.authorGultekin, Melis
dc.contributor.authorGuler, Ozan Cem
dc.contributor.authorAkyurek, Serap
dc.date.accessioned2020-03-26T20:12:19Z
dc.date.available2020-03-26T20:12:19Z
dc.date.issued2019
dc.departmentSelçuk Üniversitesien_US
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 followup 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.en_US
dc.identifier.doi10.3802/jgo.2019.30.e28en_US
dc.identifier.issn2005-0380en_US
dc.identifier.issn2005-0399en_US
dc.identifier.issue3en_US
dc.identifier.pmid30887753en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://dx.doi.org/10.3802/jgo.2019.30.e28
dc.identifier.urihttps://hdl.handle.net/20.500.12395/37418
dc.identifier.volume30en_US
dc.identifier.wosWOS:000461481000002en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherKOREAN SOC GYNECOLOGY ONCOLOGY & COLPOSCOPYen_US
dc.relation.ispartofJOURNAL OF GYNECOLOGIC ONCOLOGYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.selcuk20240510_oaigen_US
dc.subjectEndometrial Canceren_US
dc.subjectSurgeryen_US
dc.subjectRadiotherapyen_US
dc.subjectChemotherapyen_US
dc.subjectLymphatic Metastasisen_US
dc.titleA multi-institutional analysis of sequential versus 'sandwich' adjuvant chemotherapy and radiotherapy for stage IIIC endometrial carcinomaen_US
dc.typeArticleen_US

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