IMR Press / EJGO / Volume 37 / Issue 2 / DOI: 10.12892/ejgo2798.2016

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma
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1 Section of Medical Oncology, Yale University School of Medicine, Yale Comprehensive Cancer Center, New Haven, CT, USA
2 Regional Cancer Center, ProHealth Care Medical Associates, Milwaukee, WI, USA
3 Department of Hematology and Oncology, Harvard Vanguard Medical Associates, Boston, MA, USA
4 Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, University Texas Southwestern Medical Center, Dallas, TX, USA
5 Department of Therapeutic Radiology, Yale University School of Medicine, Yale Comprehensive Cancer Center, New Haven, CT, USA
6 Department of Obstetrics, Gynecology &, Reproductive Sciences. Section of Gynecologic Oncology, Yale University School of Medicine, Yale Comprehensive Cancer Center, New Haven, CT, USA
Eur. J. Gynaecol. Oncol. 2016, 37(2), 199–203; https://doi.org/10.12892/ejgo2798.2016
Published: 10 April 2016
Abstract

Purpose of investigation: 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. 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.
Keywords
Cisplatin
Ifosfamide
Vaginal brachytherapy
Uterine carcinosarcoma
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