Radiotherapy in the treatment of uterine sarcomas. A retrospective analysis of 54 cases.
BACKGROUND
In the general population, uterine sarcoma (US) is an uncommon tumor, which accounts for approximately 1-3% of all uterine neoplasms. Its biological behavior is characterized by hematogenous metastases and local recurrent growth including the pelvis and peritoneal cavity. In the management of US, surgery is the primary form of treatment. Up to now the role of adjuvant radiotherapy has not been clearly established.


METHODS
We report about 54 patients with US treated from 1954 to 1994 by surgical resection alone (22) or a combination of surgery and irradiation (32) and evaluate the influence of histology, stage and different treatment options on survival.


CONCLUSIONS
Our data indicate an increased disease-free survival for patients treated with adjuvant radiotherapy, especially if poor prognostic factors are present (advanced tumor stage, histopathological grade II or III of leiomyosarcoma and mixed mesodermal sarcoma). Postoperative irradiation using doses between 50 and 60 Gy is recommended, in selected cases brachytherapy should be added. Prospective multicentric trials including a statistically evaluable number of patients are necessary to further clarify the role of multimodality treatment programs for US.
Hoffmann
W
W
Department of Radiotherapy, University of Tübingen, Germany.
Schmandt
S
S
Kortmann
R D
RD
Schiebe
M
M
Dietl
J
J
Bamberg
M
M
D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000473:pathology / Q000532:radiotherapy; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D008648:Mesoderm; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D014594:Uterine Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*