Can chemotherapy for endometrial cancer prolong life?

What should women do if they have endometrial cancer? This is probably a question that everyone is concerned about. So today, our editor will briefly introduce to you what are the methods for treating endometrial cancer? The first choice for treating endometrial cancer is surgery. Faced with surgery, radiotherapy and chemotherapy, many endometrial cancer patients will be confused about which method will be most beneficial to them?

In principle, as long as the patient's physical condition can tolerate it, he or she should receive surgical treatment as soon as possible, unless the patient has serious medical complications and cannot tolerate surgery; or the disease has reached an advanced stage and surgical resection is difficult to perform.

First, surgery can remove the cancerous uterus and other lesions that may have metastasized, including the closely adjacent ovaries, fallopian tubes, and surrounding lymph nodes. Through surgery, the tumor can be directly eradicated to achieve the purpose of cure, or the tumor volume can be reduced to benefit the patient's prognosis. Second, surgery can correctly diagnose and stage the disease. Although most patients with endometrial cancer have undergone segmented curettage, the error rate of pathological type and degree of differentiation between curettage specimens and hysterectomy specimens is as high as 20%, and these indicators are directly related to further treatment and prognosis after surgery. Therefore, accurate clinical staging is the guarantee for choosing appropriate treatment, otherwise it is very likely to lead to excessive or insufficient treatment.

Endometrial cancer is sensitive to radiotherapy, so radiotherapy is the first choice of adjuvant treatment after surgery. Controlled studies have shown that radiotherapy can reduce the local recurrence rate of patients with moderately differentiated endometrial cancer and increase the 5-year survival rate of patients with highly differentiated endometrial cancer. If the patient is in poor physical condition, cannot tolerate surgery, or is unwilling to undergo surgery, then radiotherapy is the first choice.

Can postoperative chemotherapy prolong life in advanced endometrial cancer?

According to a report in the Journal of Clinical Oncology, women with advanced endometrial cancer who received a combination of doxorubicin and cisplatin after surgery had a significantly lower recurrence rate and a longer life expectancy.

Marcus E. Randall, MD, of the Multicenter Gynecologic Oncology Group at East Carolina University in Greenville, North Carolina, and colleagues compared recurrence and overall survival in 194 women who received 5 months of chemotherapy with doxorubicin and cisplatin with 202 women who received 1.5 months of whole-abdomen radiation therapy. The women had stage III or IV endometrial cancer and the largest tumor remaining after surgery was 2 cm. After 5 years, 55 percent of the chemotherapy group were alive, compared with 42 percent of the radiation group. Fifty percent of the chemotherapy group were free of disease, compared with 38 percent of the radiation group. The hazard ratios for death and disease progression were 0.68 and 0.71, respectively, favoring the chemotherapy group over the radiation group.

However, treatment-related side effects were more common and more severe in the chemotherapy group, particularly those affecting the blood, heart, and nervous systems, and chemotherapy led to eight deaths (4 percent) compared with five deaths (2 percent) with radiation therapy. Therefore, researchers are now studying whether carboplatin and paclitaxel have the same efficacy as doxorubicin and cisplatin but with fewer side effects.