Comparative outcomes of adjuvant chemotherapy alone versus combined chemotherapy and radiation therapy in patients with stage III endometrial cancer: a propensity score matching study.

objectiveWe compared the outcomes of adjuvant chemotherapy (CT) alone vs. adjuvant CT combined with radiation therapy (CRT) in patients with stage III endometrial cancer. All patients received 6 cycles of CT before radiation therapy (RT) were initiated. We also explored specific patient subgroups that might benefit from the addition of RT.

methodsBetween 2007 and 2019, we analyzed 118 patients after propensity score matching, with 59 patients in each group (CT alone vs. CRT). The primary endpoint was pelvic recurrence; the secondary endpoints were progression-free survival (PFS). We conducted exploratory subgroup analyses stratifying patients by stage, histological grade, lymphovascular space invasion (LVSI), and cervical involvement to assess whether these factors influenced outcomes between the 2 treatments.

resultsPatients receiving CRT had significantly lower 5-year pelvic recurrence rates than those receiving CT alone (1.8% vs. 17.9%; hazard ratio [HR]=0.09 [0.01-0.71]; p=0.004). There was no significant difference in 5-year PFS between the 2 groups overall (67.6% vs. 72.3%; HR=0.75 [0.39-1.46]; p=0.393). However, in high-risk

conclusionCompared with CT alone, CRT improved pelvic control overall and significantly improved pelvic control and PFS in high-risk