title: Efficacy and tolerability of combination cisplatin and ifosfamide chemotherapy with vaginal cuff brachytherapy in the first line treatment of uterine carcinosarcoma.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.forename: M M
authors.initials: MM
authors.lastname: Abu-Khalaf
authors.forename: M A
authors.initials: MA
authors.lastname: Raza
authors.forename: C
authors.initials: C
authors.lastname: Hatzis
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: K
authors.initials: K
authors.lastname: Lin
authors.forename: S
authors.initials: S
authors.lastname: Higgins
authors.forename: E
authors.initials: E
authors.lastname: Ratner
authors.forename: D A
authors.initials: DA
authors.lastname: Silasi
authors.forename: M
authors.initials: M
authors.lastname: Azodi
authors.forename: T J
authors.initials: TJ
authors.lastname: Rutherford
authors.forename: A Dd
authors.initials: AD
authors.lastname: Santin
authors.forename: P Ee
authors.initials: PE
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods*; D002296:Carcinosarcoma / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D015080:Mesna / Q000627:therapeutic use; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D020011:Protective Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D020011:Protective Agents; D015080:Mesna; D002945:Cisplatin; D007069:Ifosfamide