A retrospective assessment of outcomes of chemotherapy-based versus radiation-only adjuvant treatment for completely resected stage I-IV uterine carcinosarcoma Journal Article

Authors: Makker, V.; Abu-Rustum, N. R.; Alektiar, K. M.; Aghajanian, Carol A; Zhou, Q.; Iasonos, A.; Hensley, M. L.
Article Title: A retrospective assessment of outcomes of chemotherapy-based versus radiation-only adjuvant treatment for completely resected stage I-IV uterine carcinosarcoma
Abstract: Purpose: To determine the progression-free survival (PFS) and overall survival (OS) in a cohort of patients who received either platinum-based chemotherapy with or without radiation therapy (pelvic or WAI), or RT alone. Methods: Memorial Sloan-Kettering Cancer Center (MSKCC) electronic medical records from 8/1/1995 to 10/3/2007 were reviewed for patient age, diagnosis date, type of primary surgery, residual disease at the completion of primary surgery, FIGO stage, treatment details, dates of progression and death, and site(s) of first recurrence. PFS and OS by stage (I/II v III/IV) and by treatment type (chemotherapy with or without RT v RT alone) were determined using landmark analyses 8 weeks after surgery. Patients who received chemotherapy with or without RT (pelvic or abdominal) or RT alone (pelvic or abdominal) were included in the analysis. Both groups were allowed to have received intravaginal radiation therapy (IVRT). Results: Forty-nine patients met study criteria. Thirty-eight/49 patients received chemotherapy: 23/38 (60.5%) received paclitaxel-carboplatin; 7/38 (18.4%) received ifosfamide-platinum; 8/38 (21.0%) received other chemotherapy. FIGO stage was: I = 15 (31%); II = 5 (10%); III = 21 (43%); IV = 8 (16%). Three-year PFS for the entire cohort was 24%. Three-year OS for the entire cohort was 60%. Three-year median PFS time for the entire cohort was 15 months (95% CI: 11-25 months). Three-year median OS time for the entire cohort was 67 months (95% CI: 23-89 months). Three-year PFS for stages I-II was 43% v 14% for stages III-IV (HR = 1.98 [0.9-4.33]); P = 0.082. Three-year OS for stages I-II was 68% v 55% for stages III-IV (HR = 1.26 [0.47-3.41]); P = 0.648. Three-year PFS for chemotherapy with or without RT was 35% v 9% for RT alone (HR = 1.74 [0.79-3.85]); P = 0.164. Three-year OS for chemotherapy with or without RT was 66% v 34% for RT alone (HR = 2.02 [0.77-5.33]); P = 0.146. Conclusions: Our study corroborates GOG 150 results, and shows that paclitaxel-carboplatin appears to be an efficacious adjuvant chemotherapy regimen for completely resected uterine carcinosarcoma. The role of adjuvant RT in addition to chemotherapy warrants further investigation. © 2008 Elsevier Inc. All rights reserved.
Keywords: adult; cancer chemotherapy; cancer survival; clinical article; controlled study; treatment outcome; aged; disease-free survival; middle aged; retrospective studies; constipation; fatigue; neutropenia; cancer recurrence; cisplatin; diarrhea; paclitaxel; cancer radiotherapy; radiation dose; chemotherapy; cancer staging; follow up; antineoplastic agent; neoplasm staging; anorexia; carboplatin; multiple cycle treatment; neoplasm recurrence, local; radiation; lung disease; nausea; neuropathy; vomiting; antineoplastic combined chemotherapy protocols; myalgia; peripheral neuropathy; dyspareunia; ifosfamide; acute kidney failure; mesna; cystitis; uterine neoplasms; uterus sarcoma; uterus carcinoma; carcinosarcoma; abdominal radiotherapy; adjuvant treatment; proctitis; completely resected; ivrt; uterine carcinosarcoma
Journal Title: Gynecologic Oncology
Volume: 111
Issue: 2
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2008-11-01
Start Page: 249
End Page: 254
Language: English
DOI: 10.1016/j.ygyno.2008.06.035
PUBMED: 18755503
PROVIDER: scopus
PMCID: PMC3952566
Notes: --- - "Cited By (since 1996): 8" - "Export Date: 17 November 2011" - "CODEN: GYNOA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Vicky Makker
    77 Makker
  2. Kaled M Alektiar
    253 Alektiar
  3. Qin Zhou
    120 Zhou
  4. Alexia Elia Iasonos
    182 Iasonos
  5. Martee L Hensley
    222 Hensley