Randomized Phase III Crossover Trial of Chemotherapy (Doxorubicin/Cisplatin/Paclitaxel and G-CSF) Versus Hormonal Therapy (Tamoxifen/Megestrol Acetate) in Patients With Stage III & IV or Recurrent Endometrial Cancer

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Histologically confirmed primary stage III or IV or recurrent endometrial cancer

- Poor curative potential with radiotherapy or surgery (alone or in combination)

- Measurable disease

- At least one lesion accurately measured in at least one dimension

- At least 20 mm by conventional techniques, including palpation, x-ray, CT
scan, or MRI OR

- At least 10 mm by spiral CT scan

- Disease in a previously irradiated field as sole site of measurable disease
allowed only if clear progression after completion of radiotherapy

- Estrogen receptor(ER)/progesterone receptor (PR) status of primary tumor required

- ER/PR status of measurable tumor optional

PATIENT CHARACTERISTICS:

Age:

- Not specified

Performance status:

- GOG 0-2

Life expectancy:

- Not specified

Hematopoietic:

- Platelet count at least 100,000/mm^3

- Granulocyte count at least 1,500/mm^3

Hepatic:

- Bilirubin normal

- SGPT no greater than 3 times upper limit of normal

Renal:

- Creatinine no greater than 1.6 mg/dL

Cardiovascular:

- LVEF at least 50%

- No third-degree or complete heart block, unless pacemaker is in place

- Other conduction abnormalities or cardiac dysfunction allowed at the investigator's
discretion

- No history of deep venous thrombosis

- No uncontrolled angina

Pulmonary:

- No history of pulmonary embolus

Other:

- No other malignancy within the past 5 years except nonmelanoma skin cancer

- No concurrent medical illness that would preclude study

- No serious uncontrolled infection

- No serious peripheral neuropathy

- No circumstances that would preclude study compliance

- No sensitivity to E. coli-derived drug preparations

PRIOR CONCURRENT THERAPY:

Biologic therapy:

- Prior biologic therapy allowed

Chemotherapy:

- No prior cytotoxic chemotherapy, including chemotherapy for radiosensitization

Endocrine therapy:

- No prior hormonal therapy for endometrial cancer

Radiotherapy:

- See Disease Characteristics

- At least 4 weeks since prior radiotherapy involving the whole pelvis or more than 50%
of the spine

Surgery:

- See Disease Characteristics

Other:

- Concurrent cardiac conduction-altering medications such as digitalis, beta blockers,
or calcium channel blockers allowed at the investigator's discretion