Sequential versus "sandwich" sequencing of adjuvant chemoradiation for the treatment of stage III uterine XXXX .

@entity1 @entity137 @entity5 @entity3003 @entity900 @entity1311 @entity1168 @entity4348
OBJECTIVE: To compare the efficacy and tolerance of adjuvant chemotherapy and radiotherapy delivered in sequential (chemotherapy followed by radiation) versus "sandwich" fashion (chemotherapy, interval radiation, and remaining chemotherapy) after surgery in @entity1 with FIGO stage III uterine @entity4348 . METHODS: From 2004 to 2011, we identified 51 @entity1 treated at our institution fitting the above criteria. All @entity1 received surgical staging followed by adjuvant chemoradiation (external-beam radiation therapy (EBRT) with or without @entity1168 ( @entity1168 ) vaginal brachytherapy (VB)). Of these, 73% and 27% of @entity1 received their adjuvant therapy in sequential and sandwich fashion, respectively. RESULTS: There were no significant differences in clinical or pathologic factors between @entity1 treated with either regimen. Thirty-nine (76%) @entity1 had stage IIIC disease. The majority of @entity1 received 6cycles of @entity1311 with @entity3003 or @entity900 . Median EBRT dose was 45Gy and 54% of @entity1 received @entity1168 VB boost (median dose 21Gy). There were no significant differences in the estimated 5-year overall survival, local progression-free survival, and distant metastasis-free survival between the sequential and sandwich groups: 87% vs. 77% (p=0.37), 89% vs. 100% (p=0.21), and 78% vs. 85% (p=0.79), respectively. No grade 3-4 genitourinary or gastrointestinal @entity137 were reported in either group. There was a trend towards higher incidence of grade 3-4 hematologic @entity137 in the sandwich group. CONCLUSION: Adjuvant chemoradiation for FIGO stage III endometrioid uterine @entity5 given in either sequential or sandwich fashion appears to offer equally excellent early clinical outcomes and acceptably low @entity137 .
