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Carboplatin-Paclitaxel Versus Cisplatin-Ifosfamide in the Treatment of Uterine Carcinosarcoma: A Retrospective Cohort Study

Lorusso, Domenica MD; Martinelli, Fabio MD; Mancini, Maria MD; Sarno, Italo MD; Ditto, Antonino MD; Raspagliesi, Francesco MD

International Journal of Gynecological Cancer: September 2014 - Volume 24 - Issue 7 - p 1256–1261
doi: 10.1097/IGC.0000000000000215
Uterine Cancer

Objective: Uterine carcinosarcoma (CS) is a rare neoplasm whose adjuvant treatment has not been yet defined. We report on the activity and toxicity of cisplatin-ifosfamide and carboplatin-paclitaxel as adjuvant treatments for patients with uterine CS.

Methods: Data of International Federation of Gynecology and Obstetrics (FIGO) stage I to IV uterine CS patients treated between 2006 and 2012 with adjuvant chemotherapy (cisplatin 20 mg/mq and ifosfamide 1500 mg/mq day 1 to 4 every 3 weeks plus prophylactic Granulocyte colony-stimulating factor (G-CSF) support [group A] or carboplatin area under the curve -5 (AUC-5) and paclitaxel 175 mg/mq d1q21 [group B]) were retrospectively reviewed. Progression-free survival, overall survival, and chemotherapy-related toxicities were compared between the 2 groups. A subanalysis of oncologic outcomes according to the sarcomatous component (homologous vs heterologous) was performed.

Results: Forty-six women were evaluated—21 in group A and 25 in group B. At a median follow-up of 30 months, the median progression-free survival was 11.6 months (95% confidence interval [CI], 6.3–16.9) and 16.6 months (95% CI, 14.7–18.5) for group A and B, respectively (P = 0.20). The median overall survival was 17.1 months (95% CI, 12.6–21.5) and 35.1 months (95% CI, 26.3–43.7) for group A and B, respectively (P = 0.14). No differences were identified among heterologous or homologous components according to chemotherapy treatment. Toxicity profiles widely differ between treatment arms.

Conclusions: Because of the super imposable activity and the better toxicity profile, carboplatin-paclitaxel may be a suitable alternative to cisplatin-ifosfamide in the treatment of uterine CS.

Department of Gynecologic Oncology, IRCCS Foundation National Cancer Institute, Milan, Italy.

Address correspondence and reprint requests to Domenica Lorusso, MD, Department of Gynecologic Oncology, IRCCS Foundation National Cancer Institute, Via Venezian 1, 20133 Milan, Italy. E-mail: kettalorusso@libero.it.

The authors have no financial disclosures.

The authors declare no conflicts of interest.

No funds have been received.

Received March 12, 2014

Received in revised form June 10, 2014

Accepted June 10, 2014

© 2014 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.