Despite the paucity of strong data showing benefit of chemotherapy + radiotherapy in patients with stage I-II high risk histology endometrial cancer, if you recommend treatment with both modalities, how do you determine treatment schedule?
For the purpose of this answer, I'll define high risk as serous, carcinosarcoma, undifferentiated, and dedifferentiated. Clear cell carcinoma can be considered and likely treated more by its molecular profile. As you indicate, there is little data to support the routine use of chemotherapy for FIGO ...
It is difficult to conduct a study with enough power to adequately evaluate the benefits of adjuvant therapy in early stage, high risk uterine cancer subtypes. I, therefore, base my utility of adjuvant therapy on their well-known aggressive behavior. If the patient is fully staged, I would typically...
To date, chemotherapy and radiation sequencing for endometrial cancer has not been evaluated in any prospective randomized trials. The regimens with the most data include chemoradiation followed by chemotherapy as in RTOG-9708 (Phase 2) and in the Phase 3 PORTEC-3 and GOG 258 trials. However, GOG 24...