Efficacy of postoperative radiotherapy combined with taxol plus carboplatin chemotherapy regimens in the treatment of high-risk early-stage endometrial cancer

Purpose: To compare the efficacy and safety of postoperative extrapelvic irradiation intensity-modulated radiotherapy (IMRT)+concurrent chemotherapy and vaginal brachytherapy (VBT)+concurrent chemotherapy in the treatment of patients with high-risk early-stage endometrial cancer, and analyze the influencing factors for the prognosis of patients. Methods: A total of 126 patients with high-risk stage Ic-IIa endometrial cancer were divided into extrapelvic irradiation IMRT + concurrent taxol+carboplatin (TC) chemotherapy group (IMRT group, n=63) and VBT + concurrent TC chemotherapy group (VBT group, n=63). Then, the efficacy and the incidence rate of adverse reactions were compared between the two groups of patients. Additionally, the possible influencing factors for the prognosis of patients were analyzed. Results: In the Functional Assessment of Cancer Therapy-General Version 4 (FACT-G-V4) scale for the quality of life of patients, the scores of physiological status, social/family status, emotional status and functional status were dramatically higher in the VBT group than in the IMRT group at 3 months after treatment. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 87.3% and 73.0% in the IMRT group and 82.5% and 66.7% in the VBT group, respectively. Furthermore, advanced age, lower uterine segment involvement and anemia before treatment were independent risk factors for tumor progression in patients with endometrial cancer. Conclusions: For patients with high-risk early-stage endometrial cancer, postoperative VBT + concurrent TC chemotherapy has similar efficacy to postoperative extrapelvic irradiation IMRT + concurrent TC chemotherapy, but patients receiving the former have fewer adverse reactions and high quality of life. Advanced age, lower uterine segment involvement and anemia before treatment are independent risk factors affecting tumor progression in such patients.