Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma

M. M. Abu-Khalaf, M. A. Raza, C. Hatzis, H. Wang, K. Lin, S. Higgins, E. Ratner, D. A. Silasi, M. Azodi, T. J. Rutherford, A. D. Santin, P. E. Schwartz

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose of investigation: A retrospective study to evaluate six cycles of cisplatin 40 mg/m2 on day 1 and ifosfamide 1, 200 mg/m2 daily on days 1 to 4 with Mesna every four weeks as first line treatment for 29 patients with a diagnosis of uterine carcinosarcoma. Materials and Methods: A total of 23 of 29 patients received high dose rate intracavitary vaginal cuff brachytherapy (VCBT) with two fractions of seven Gy each. Median age was 65 years (range 40-82); 13 (44.8%) had Stage I disease, three (10.3%) had Stage II, eight (27.6%) had Stage III, and five (17.2%) patients had Stage IV disease. Results: Most common toxicities were anemia grade 1 (35%)/grade 2 (45%), and neutropenia grade 3 (17%)/grade 4 (6.9%). Eleven dose modifications, four treatment discontinuations, and one patient withdrawal occurred. At a median follow up of 45 months (range 9 to 144), Progression free survival (PFS) was 20% and overall survival (OS) was 40% for Stage IV, PFS 75% and OS 62.5% for Stage III, compared to a PFS 75 % and OS 72.2% for Stages I-II. Median OS for the entire group was 12.43 years (95% CI 3.69 to inf); for Stage I-III 12.4 years (6.1 to inf), and for Stage IV 15.6 months (95% CI 9.4 to inf). Conclusions: Cisplatin and ifosfamide chemotherapy with VCBT was well tolerated and has promising activity in uterine carcinosarcoma.

Original languageEnglish (US)
Pages (from-to)199-203
Number of pages5
JournalEuropean Journal of Gynaecological Oncology
Volume37
Issue number2
DOIs
StatePublished - Jan 1 2016

Keywords

  • Cisplatin
  • Ifosfamide
  • Uterine carcinosarcoma
  • Vaginal brachytherapy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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