As reported in the Journal of Clinical Oncology by Matei et al, the final overall survival analysis in the long-term follow-up of the phase III NRG258 trial has shown no difference between adjuvant chemoradiation (C-RT) vs chemotherapy (CT) in patients with locally advanced endometrial carcinoma. The initial report from the trial showed a benefit of C-RT in local recurrence but not in recurrence-free survival.
Study Details
In the U.S. multicenter trial, 736 eligible patients with International Federation of Gynecology and Obstetrics (FIGO) stage III or IVA disease of any histologic subtype were randomly assigned between June 2009 and July 2014 to receive C-RT (n = 370) or chemotherapy alone (n = 366). C-RT consisted of cisplatin and volume-directed radiation therapy followed by carboplatin and paclitaxel for four cycles; chemotherapy consisted of carboplatin and paclitaxel for six cycles. The primary endpoint was recurrence-free survival.
Key Findings
As previously reported, C-RT did not significantly improve recurrence-free survival vs chemotherapy alone (hazard ratio [HR] = 0.90 (90% confidence interval [CI] = 0.74–1.10). With median follow-up of 112 months (maximum, 155 months), median overall survival was not reached in either the C-RT group or the chemotherapy-alone group. The total numbers of death were 134 in the C-RT group and 125 in the chemotherapy group (HR = 1.05, 95% CI = 0.82–1.34, P = .72).
In subgroup analyses, no significant benefit of C-RT was found according to FIGO stage, patient age, race, gross residual disease, histology, lymph-vascular space invasion, or body mass index.
The investigators concluded: “Although C-RT reduced the rate of local recurrence compared with CT, it did not increase [overall survival or recurrence-free survival] in stage III/IVA [endometrial cancer].”
Daniela E. Matei, MD, of Northwestern University, Chicago, is the corresponding author of the Journal of Clinical Oncology article.
Disclosure: The study was supported by grants from the National Cancer Institute. For full disclosures of the study authors, visit ascopubs.org.
