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, Ken Yu Lin, S. Higgins, E. Ratner, D. A. Silasi, M. Azodi, T. J. Rutherford, A. D. Santin, P. E. Schwartz

Research output: Contribution to journalArticle

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
Externally publishedYes

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Carcinosarcoma
Ifosfamide
Brachytherapy
Cisplatin
Disease-Free Survival
Drug Therapy
Survival
Mesna
Therapeutics
Neutropenia
Anemia
Retrospective Studies

Keywords

  • Cisplatin
  • Ifosfamide
  • Uterine carcinosarcoma
  • Vaginal brachytherapy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma. / Abu-Khalaf, M. M.; Raza, M. A.; Hatzis, C.; Wang, H.; Lin, Ken Yu; Higgins, S.; Ratner, E.; Silasi, D. A.; Azodi, M.; Rutherford, T. J.; Santin, A. D.; Schwartz, P. E.

In: European Journal of Gynaecological Oncology, Vol. 37, No. 2, 01.01.2016, p. 199-203.

Research output: Contribution to journalArticle

Abu-Khalaf, MM, Raza, MA, Hatzis, C, Wang, H, Lin, KY, Higgins, S, Ratner, E, Silasi, DA, Azodi, M, Rutherford, TJ, Santin, AD & Schwartz, PE 2016, 'Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma', European Journal of Gynaecological Oncology, vol. 37, no. 2, pp. 199-203. https://doi.org/10.12892/ejgo2798.2016
Abu-Khalaf, M. M. ; Raza, M. A. ; Hatzis, C. ; Wang, H. ; Lin, Ken Yu ; Higgins, S. ; Ratner, E. ; Silasi, D. A. ; Azodi, M. ; Rutherford, T. J. ; Santin, A. D. ; Schwartz, P. E. / Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma. In: European Journal of Gynaecological Oncology. 2016 ; Vol. 37, No. 2. pp. 199-203.
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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.",
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AU - Raza, M. A.

AU - Hatzis, C.

AU - Wang, H.

AU - Lin, Ken Yu

AU - Higgins, S.

AU - Ratner, E.

AU - Silasi, D. A.

AU - Azodi, M.

AU - Rutherford, T. J.

AU - Santin, A. D.

AU - Schwartz, P. E.

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