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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-three patients with advanced or recurrent endometrial carcinoma no longer amenable to management with surgery or radiotherapy were treated with adriamycin. Sixteen of the 43 patients demonstrated objective response to drug therapy with a greater than or equal to 50% reduction in the size of measurable disease. There were 11 complete responses among these 16 responders. Responders had a significantly better survival than nonresponders (P less than 0.05). Initial performance status was the only factor of demonstrable prognostic significance. Toxicity was similar to that observed in other phase II trials of adriamycin. Adriamycin, based on these data, is an active agent in the treatment of advanced or recurrent endometrial carcinoma.
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PMID:Phase II trial of adriamycin in the treatment of advanced or recurrent endometrial carcinoma: a Gynecologic Oncology Group study. 36 91

Uterine papillary serous carcinoma (UPSC) is an aggressive malignancy that accounts for a disproportionate number of intraabdominal failures among endometrial carcinoma patients. The histologic appearance and tendency toward intraabdominal spread resemble those of papillary serous adenocarcinoma of the ovary. Because approximately 70% of untreated ovarian carcinoma patients respond to platinum-based chemotherapy, it has been suggested that UPSC patients might respond to similar treatment regimens. Twenty patients with UPSC were treated with cisplatin, doxorubicin (Adriamycin), cyclophosphamide (PAC) chemotherapy between January 1982 and December 1989. They included 9 patients with advanced primary disease, 5 with recurrence, and 6 who received PAC as adjuvant therapy. Patients received a mean of five cycles of PAC. Only 2 of 11 patients with measurable disease greater than 2 cm achieved complete clinical responses of 12 and 31 months duration; there were no partial responses. Actuarial 5-year survival for all patients was 23%. The mean progression-free interval was 9 months. Patients with clinical stages I or II disease had a higher survival rate than those with stage III or IV disease (P = 0.003). Survival did not correlate with depth of myometrial invasion (P = 0.81) or size of residual tumor following initial surgery (P = 0.16). Estrogen or progesterone receptors were detected in 10 of 11 tumors tested. Seven of 9 patients tested had elevated serum levels of CA-125 (greater than 35 U/ml). Correlation between CA-125 value and clinical course was demonstrated in 3 of 5 patients who had serial measurements. Of all patients, 3 are currently alive; 1 has documented disease. Moderate to severe toxicity was seen in 14 patients (70%). There was one possible treatment-related death from cardiomyopathy. UPSC, despite its histologic and clinical similarities to ovarian carcinoma, was relatively resistant to PAC chemotherapy in this mixed group of patients.
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PMID:Uterine papillary serous carcinoma (UPSC) treated with cisplatin, doxorubicin, and cyclophosphamide (PAC). 152 8

We conducted a retrospective review of 44 patients with metastatic or recurrent endometrial carcinoma treated with cisplatin, doxorubicin, cyclophosphamide, and medroxyprogesterone acetate. Thirty-six women had metastatic disease; eight had recurrent disease. In the metastatic group, 12 women had positive peritoneal cytology as the only criterion for metastatic disease. Grade 1 tumors represented 25%, grade 2, 47.7%, and grade 3, 27.3%. The series was divided into four groups based on disease volume before chemotherapy: positive peritoneal cytology only (N = 12), microscopic (N = 11), macroscopic less than 2 cm (N = 6), and macroscopic greater than 2 cm (N = 15). Fifteen patients had measurable disease and eight (53%) had an objective response. The median survival was 31 months for the whole group. Median survivals were not reached for the positive peritoneal cytology only and the microscopic groups. Median survival for the macroscopic less than 2 cm and greater than 2 cm groups were 15 and 10 months, respectively (P less than .0001). The volume of disease was the most important factor in determining survival as well as the time to progression (P less than .0001). The distribution of grade was similar in all groups (P = .88), and grade did not predict survival (P = .80) or recurrence (P = .87). The significant number of low-grade lesions in our series as well as the importance of positive cytology as a predictor of survival underscore the need for surgical pathologic staging in an effort to identify those patients in need of adjuvant therapy.
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PMID:Treatment of recurrent and metastatic adenocarcinoma of the endometrium with cisplatin, doxorubicin, cyclophosphamide, and medroxyprogesterone acetate. 194 3

Both single-agent cisplatin and the combination of doxorubicin and cyclophosphamide demonstrated moderate activity against endometrial carcinoma in earlier salvage trials. Since January 1979, 102 patients with advanced primary (n = 42) or recurrent (n = 60) endometrial carcinoma were prospectively treated with cisplatin (50 mg/m2), doxorubicin (50 mg/m2), and cyclophosphamide (500 mg/m2) (PAC). PAC was administered monthly until disease progression or toxicity precluded additional therapy. Patients received a median of five treatment cycles (range 1-13). Of the 87 patients with measurable disease, 12 had a complete clinical response, while 27 had a partial clinical response, for an overall objective response rate of 45%. No differences in response rates between primary and recurrent disease patients were noted. Median time to response was 2.5 months with a median response duration of 4.8 months. Nonresponders included 33 patients with stable disease and 15 with progression. Median progression-free survival for all patients was 6 months. Dose escalation was possible in 25% of patients; however, 52% of patients required dose reductions during treatment. Clinically significant toxicities included neutropenia (65%), anemia (47%), emesis (21%), nephrotoxicity (17%), and neurotoxicity (4%). Our study indicates that endometrial cancer is significantly responsive to PAC. Enthusiasm for this regimen should be tempered by the limited duration of response and substantial treatment toxicity.
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PMID:Prospective treatment of advanced or recurrent endometrial carcinoma with cisplatin, doxorubicin, and cyclophosphamide. 201 51

Serial serum CA-125 levels were measured in fifteen patients with recurrent or advanced endometrial carcinoma during treatment with chemo- or hormonal therapy. All patients had measurable disease by physical examination, chest X-ray or CT scan. Serum CA-125 levels were invariably elevated, and generally reflected, response to therapy in all patients with intraperitoneal or pulmonary metastases. Levels were normal in two of three patients with isolated vaginal metastases prior to and following response to progesterone.
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PMID:Use of serum CA-125 levels to monitor therapy of patients with advanced or recurrent endometrial carcinoma. 280 20

Persistent or recurrent peritoneal carcinomatosis (PC) documented at second-look surgery has proved relatively refractory to second-line therapy. The majority of these tumors do not respond to cisplatin based chemotherapy. Because of the relatively high response rate we observed with systemically administered mitomycin C plus 5-fluorouracil, we initiated a trial of intraperitoneal (IP) mitomycin C (10 mg/m2 in 2 L dialysate fluid every 4 weeks) in 14 patients with refractory PC secondary to gynecologic malignancies. All but one patient had PC secondary to ovarian cancer documented at second-look cytoreductive surgery following intense cisplatin based drug therapy. One patient had endometrial cancer and had been treated previously with radiation. In all, 49 courses of intraperitoneal mitomycin C were administered to 14 patients. Systemic toxicity was minimal, except for mild thrombocytopenia that occurred in four patients. However, abdominal pain due to chemical peritonitis was cumulative and dose limiting after three to five courses of therapy. Of the seven patients with measurable disease (positive serum CA-125 or intraperitoneal cytology), six had normalization of at least one of these two parameters. Eight of the 14 patients remain alive without clinical evidence of disease with a median follow-up duration of 10 months. We conclude that IP mitomycin C is a well-tolerated and potentially effective treatment modality in patients with limited PC following second-look surgical debulking for gynecologic malignancy.
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PMID:Intraperitoneal mitomycin C in the treatment of peritoneal carcinomatosis following second-look surgery. 313 95

Seven patients with uterine endometrial carcinoma received a postoperative combination chemotherapy with ifosfamide (1g/m2) daily for 5 days, and adriamycin (50mg/m2) and cisplatin (50mg/m2) on day 1 (IAP). All except one patient with the disease without myometrial invasion received 5 courses or more of IAP treatment. Of four patients with measurable disease, three achieved complete response (CR) and the other patient obtained partial response (PR), indicating a 100% response rate. In the PR case, the patient had previously been treated by radiation treatment for cervical cancer, and the histology of the tumor was papillary serous adenocarcinoma, a malignant variant of endometrial cancer. Six patients underwent second look operation following the planned IAP treatment courses, and the operation confirmed no pathological evidence of disease in any, although in one disease recurred 7 months after the second laparotomy. Side effects were remarkable, including an 87% incidence of grade 4 leucopenia. However, the patients recovered spontaneously from the hematologic toxicity within 3 weeks of treatment. Other toxic effects including central nervous system toxicity were controllable and acceptable. The results indicated that IAP combination therapy was feasible and promising in the management of patients with endometrial carcinoma.
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PMID:A preliminary study of a combination chemotherapy with ifosfamide, adriamycin and cisplatin for endometrial carcinoma. 320 14

The objective of the present phase II trial was to analyze the efficacy of the antiestrogen tamoxifen in advanced endometrial carcinoma. 32 patients with measurable disease entered the study and were treated with tamoxifen 10 mg 3 times daily. Among 26 patients with evaluable disease remission (partial and complete) was achieved in 8 (30%), no change in 7 (27%) and progressive disease in 11 (42%). Duration of response was significantly longer in 4 patients with complete remission (30.5 + months) compared to patients with partial remission and no change. No correlation was found between response to treatment with tamoxifen and disease free interval but a favourable connection was observed between good response and low grade of anaplasia of the tumor. 9 of the patients had received prior treatment with MPA. No complete cross resistance or cross sensitivity between MPA and tamoxifen was apparent.
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PMID:Tamoxifen treatment of advanced endometrial carcinoma. A phase II study. 687 94

Between April 1985 and February 1989, 19 patients with advanced or recurrent endometrial carcinoma were treated with the combination of cisplatin (50 mg/m2) and doxorubicin (50 mg/m2) administered intravenously every 21 days. Eight patients had Stage III disease, two had Stage IV and nine had recurrent cancer. Eleven patients had measurable disease at the start of therapy. There were 7 partial responses among the 19 patients, for an overall response rate of 36%. The median survival for the whole group was 17 months with a median progression free interval of 5 months. Patients without measurable disease at the onset of therapy had median survivals and progression free intervals which were significantly better than those patients with measurable disease, p < 0.011 and p < 0.025 respectively. Granulocytopenia (< 1000 microliters) occurred in 7 patients. No important thrombocytopenia, cardiotoxicity nephrotoxicity or neurotoxicity was observed. Emesis and alopecia occurred in all patients. No treatment related deaths were encountered.
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PMID:Treatment of recurrent and metastatic endometrial carcinoma with cisplatin and doxorubicin. 795 32

Cisplatin and the combination of cisplatin, doxorubicin, and cyclophosphamide have documented activity in women with advanced or recurrent endometrial adenocarcinoma. However, response duration has been short and toxicity is substantial. To determine if similar activity could be obtained with less morbidity, we prospectively treated 33 patients with 360 mg/m2 carboplatin given intravenously every 28 days. Mean patient age was 69 years (range 40-86); all had a Zubrod functional status of 2 or less. Seventeen patients had advanced primary tumors, and 16 had recurrent disease. Prior treatment included surgical resection in 29 cases, hormonal agents in 7, and radiotherapy in 22. No patient had received prior chemotherapy. Mean treatment was 5.7 cycles. Nine of 27 patients (33%) with measurable disease had objective responses, including three complete and six partial responses. Nonresponders included 10 patients with stable disease and 8 whose disease progressed while on treatment. Median time to response was 3 months. Median progression-free survival for responders and nonresponders was 5 and 4 months, respectively. At analysis, 20 patients had died of disease, 7 were alive with disease, and 6 were clinically free of disease. Disease-free patients include 1 with a complete response and 5 who began treatment without measurable disease. Median follow-up for surviving patients was 18 months (range 4-32). Treatment toxic effects were minimal and largely limited to myelosuppression; 3 patients had grade 3 thrombocytopenia, 1 had grade 3 neutropenia, and 5 had grade 3 anemia. Carboplatin has define activity in endometrial carcinoma and offers a well-tolerated palliative therapeutic alternative.
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PMID:Treatment of advanced or recurrent endometrial carcinoma with single-agent carboplatin. 811 51


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