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Chemotherapy, Radiation, or Combination Therapy for Stage III Uterine Cancer
- Source :
- Obstet Gynecol
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Objective To compare the outcomes of women with stage III uterine cancer treated with chemotherapy alone, external beam radiation alone, and combination chemotherapy and radiation. Methods The National Cancer Database was used to identify women with stage III endometrioid, serous, and clear cell uterine cancer treated with either chemotherapy (with or without vaginal brachytherapy) alone, external beam radiation (with or without brachytherapy), or combination chemotherapy and external beam radiation (with or without vaginal brachytherapy) from 2004 to 2015. Survival was estimated using Cox proportional hazards models and adjusted survival curves after propensity score analysis using inverse probability of treatment weighting to balance the clinical and demographic characteristics between the cohorts. Results Of the 20,873 patients identified, 9,456 (45.3%) received chemotherapy alone, 2,417 (11.6%) were treated with radiation alone, and 9,000 (43.1%) received chemotherapy in combination with external beam radiation. Use of combination therapy was 33.0% in 2004, and then rose to 50.5% in 2015. The mortality of the cohort was 33.1% and median survival was 115 months. Within the cohort, combination therapy was associated with a 23% reduction in mortality (hazard ratio [HR]=0.77; 95% CI 0.73-0.80) compared with chemotherapy alone. Similar findings of decreased mortality were noted in subgroup analyses for both stage IIIA (HR=0.81; 95% CI 0.68-0.98) and stage IIIC (HR=0.79; 95% CI 0.75-0.84) tumors. Similarly, when compared with radiation alone, combination therapy was accompanied by a 19% decrease in mortality (HR=0.81; 95% CI 0.73-0.89). Combination chemoradiation was associated with decreased mortality across all of the histologic subtypes. Conclusion Among women with stage III uterine cancer, combination chemotherapy and external beam radiation is associated with decreased mortality compared with chemotherapy or radiation alone.
- Subjects :
- medicine.medical_specialty
Databases, Factual
Combination therapy
medicine.medical_treatment
Brachytherapy
Urology
Hysterectomy
Article
03 medical and health sciences
0302 clinical medicine
Uterine cancer
Humans
Medicine
030212 general & internal medicine
Survival analysis
Aged
Neoplasm Staging
Proportional Hazards Models
Aged, 80 and over
030219 obstetrics & reproductive medicine
business.industry
Hazard ratio
Obstetrics and Gynecology
Cancer
Combination chemotherapy
Middle Aged
medicine.disease
Combined Modality Therapy
Survival Analysis
United States
Cystadenocarcinoma, Serous
Radiation therapy
Chemotherapy, Adjuvant
Uterine Neoplasms
Female
Radiotherapy, Adjuvant
business
Carcinoma, Endometrioid
Adenocarcinoma, Clear Cell
Subjects
Details
- ISSN :
- 00297844
- Volume :
- 134
- Database :
- OpenAIRE
- Journal :
- Obstetrics & Gynecology
- Accession number :
- edsair.doi.dedup.....e46a261da7481fe95d294ba191db43fd