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Combined Chemotherapy and Radiotherapy Improve Survival in High-Risk Endometrial Cancer

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Combined Chemotherapy and Radiotherapy Improve Survival in High-Risk Endometrial Cancer

Endometrial cancer starts in the lining of the womb. Some women have a high risk of the cancer returning after surgery. Doctors often use radiotherapy to lower this risk. A large international study called PORTEC-3 looked at whether adding chemotherapy to radiotherapy could help women live longer.

The study followed 660 women with high-risk endometrial cancer for about ten years. Half received radiotherapy alone. The other half received both radiotherapy and chemotherapy. After ten years, women who had both treatments lived longer and had fewer cancer recurrences. The chance of being alive ten years later was around 74% with combined treatment, compared to 67% with radiotherapy alone.

Researchers also studied the cancerโ€™s genetic features. They found that women whose tumours had a p53 abnormality benefited the most from the combined treatment. Their survival was much higher with chemoradiotherapy than with radiotherapy alone. Women with other tumour types, such as MMRd or POLEmut, did not gain much extra benefit from chemotherapy.

This means that not all women with endometrial cancer need the same treatment. Knowing the tumourโ€™s molecular type can help doctors choose the best therapy. For some women, radiotherapy alone may be enough. For others, adding chemotherapy could make a real difference.

The findings give doctors clearer guidance on how to personalise care for women with high-risk endometrial cancer. Testing the tumour for molecular markers like p53 can help decide who will benefit most from combined treatment.

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