CISPLATIN, ADRIAMYCIN, ETOPOSIDE, MEGESTROL-ACETATE VERSUS MELPHALAN,5-FLUOROURACIL, MEDROXYPROGESTERONE ACETATE IN THE TREATMENT OF ENDOMETRIAL CARCINOMA

Fifty consecutive patients with documented advanced or recurrent endom etrial carcinoma from 1978 through 1985 were prospectively treated wit h melphalan, 5-fluorouracil, medroxyprogesterone acetate (MFP) as firs t-line chemotherapy. From 1987 through 1993, 50 consecutive patients w ith documented advanced or recurrent endometrial carcinoma were prospe ctively treated with cisplatin, Adriamycin, etoposide, megestrol aceta te (PAV-M) as first-line chemotherapy. Response rates for MFP versus P AV-M, 2- and 5-year survival, median survival, 2- and 5-year progressi on-free survival, and median progression-free survival were not statis tically different. However, there was a significant improvement favori ng PAV-M in 2-year (45 versus 14%), 5-year (30 versus 5%), and median survival (22.3 versus 8.7 months) (P = 0.008) compared to MFP in patie nts with primary advanced endometrial adenocarcinoma. Moreover, there was a significant improvement in 2- and 5-year and median survival (55 and 15% and 26.7 months) for PAV-M compared to MFP (7 and 0% and 7.3 months) (P = 0.002) for the more aggressive other adenocarcinomas (ade nosquamous, clear cell, papillary serous, undifferentiated) compared t o the more common endometrioid adenocarcinoma. The current data sugges t that cisplatin- and adriamycin-based chemotherapy results in some lo ng-term survival benefit for patients with primary advanced endometria l adenocarcinoma and the more aggressive nonendometrioid adenocarcinom a histologies. (C) 1995 Academic Press, Inc.