RT  - European Journal of Gynaecological Oncology
ID  - 10.12892/ejgo2798.2016
T1  - Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma
A1  - M.M. Abu-Khalaf
A1  - M.A. Raza
A1  - C. Hatzis
A1  - H. Wang
A1  - K. Lin
A1  - S. Higgins
A1  - E. Ratner
A1  - D.A. Silasi
A1  - M. Azodi
A1  - T.J. Rutherford
A1  - A.D. Santin
A1  - P.E. Schwartz
K1  - Cisplatin; Ifosfamide; Vaginal brachytherapy; Uterine carcinosarcoma.
YR  - 2016
SP  - 199
AB  - <p><i>Purpose of investigation: </i>Aretrospective 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. <i>Materials and Methods: </i>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. <i>Results: </i>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). <i>Conclusions: </i>Cisplatin and ifosfamide chemotherapy with VCBT was well tolerated and has promising activity in uterine carcinosarcoma.</p>