Efficacy
At a median follow up of 72.6 months, the 5-year OS was 81.4% (95% CI, 77.2 to 85.8) for patients in the chemoradiation group versus 76.1% (95% CI, 71.6 to 80.9) for patients in the radiation therapy group (HR=0.70, 95% CI, 0.51 to 0.97; p=0.034).r
The 5-year FFS was 76.5% (95% CI, 71.5 to 80.7) in the chemoradiation group versus 69.1% (95% CI, 63.8 to 73.8%) in the radiation therapy group (HR=0.70, 95% CI, 0.52 to 0.94; p=0.016).
Distant metastases were the first site of recurrence in most patients with a relapse, occurring in 78 (23.6%) women in the chemoradiation group (5-year probability 21.4%; 95% CI, 17.3 to 26.3) versus 98 (29.7%) in the radiation therapy group (5-year probability 29.1%; 95% CI, 24.4 to 34.3), with a HR of 0.74 (95% CI, 0.55 to 0.99; p=0.047).
5-year OS for stage III endometrial cancer was 78.5% (95% CI, 72.2 to 85.4) in the chemoradiation group versus 68.5% (95% CI, 61.2 to 76.7) in the radiation therapy group (HR=0.63, 95% CI, 0.41 to 0.99; p=0.043). 5-year FFS for stage III cancer was 70.9% (95% CI, 62.9 to 77.4) versus 58.4% (95% CI, 49.8 to 66.0) respectively (HR=0.61, 95% CI, 0.42 to 0.89; p=0.011). Outcomes for serous endometrial cancers were worse compared to non-serous subtypes. 5-year OS in this subgroup was 71.4% (95% CI, 60.1 to 84.7) in the chemoradiation group versus 52.8% (95% CI, 40.6 to 68.6) in the radiation therapy group (HR=0.48, 95% CI, 0.24 to 0.96; p=0.037). 5-year FFS was 59.7% (95% CI, 45.1 to 71.6) versus 47.9% (95% CI, 33.9 to 60.6) respectively (HR=0.42, 95% CI, 0.22 to 0.80, p=0.008).
Kaplan-Meier curves for overall survival (A) and failure-free survival (B) in all patientsr
© Lancet Oncol 2019
QOL data was available for 570 patients. EORTC QLQ-C30 and health related QOL were worse for the chemoradiation group at completion of radiation therapy and at 6 months. At 12 and 24 months, the only statistically significant difference between the two cohorts was the rate of sensory neuropathy, which was more common in the chemoradiation group.r,r