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Adjuvant chemotherapy with cisplatin, ifosfamide, and doxorubicin followed by radiotherapy in localized uterine sarcomas: results of a case-control study with radiotherapy alone
  1. P. PAUTIER*,
  2. A. REY,
  3. C. HAIE-MEDER,
  4. P. KERBRAT§,
  5. J. L. DUTEL,
  6. P. GESTA**,
  7. F. BRYARD††,
  8. P. MORICE‡‡,
  9. P. DUVILLARD§§ and
  10. C. LHOMMÉ*
  1. *Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, France
  2. Department of Biostatistics, Institut Gustave-Roussy, Villejuif, France
  3. Department of Radiotherapy, Institut Gustave-Roussy, Villejuif, France
  4. §Department of Medical Oncology, Centre Eugène-Marquis, Rennes, France
  5. Hôpital de Beauvais, Beauvais, France
  6. **Centre hospitalier de Niort, Niort, France
  7. ††Centre hospitalier de Sens, Institut Gustave-Roussy, Villejuif, France
  8. ‡‡Department of Surgery, Institut Gustave-Roussy, Villejuif, France
  9. §§Department of Pathology, Institut Gustave-Roussy, Villejuif, France
  1. Address correspondence and reprint requests to: Dr Patricia Pautier, Service de Gynécologie Médicale, Institut Gustave-Roussy, 39 rue Camille-Desmoulins, 94805 Villejuif Cedex, France. Email: pautier{at}igr.fr

Abstract

Uterine sarcoma is a poor prognosis disease, with a high risk of metastatic relapse. We conducted a study of adjuvant chemotherapy with cisplatin, ifosfamide, and doxorubicin followed by radiotherapy (n = 18). The results were then compared in a matched case-controlled study to radiotherapy alone (n = 16) or no therapy at all (n = 2). Chemotherapy consisted in three cycles of adriamyein-platinum-ifosfamide (API) (doxorubicin 60 mg /m2 on day 1; cisplatin 100 mg /m2 on day 2; ifosfamide 5 g /m2 on day 1 + mesna 5 g /m2 on day 1 + granulocyte colony-stimulating factor; q 3 weeks). Drug doses were reduced (20% for ifosfamide and cisplatin) four times (four patients) due to hematologic toxicity. Compared to a case-control study of adjuvant radiotherapy alone, results were not decreased by the addition of a toxic chemotherapy.

Conclusion Adjuvant API chemotherapy followed by radiotherapy is a feasible protocol; a multicenter phase III study comparing radiotherapy alone versus API chemotherapy followed by radiotherapy just began in France.

  • adjuvant
  • chemotherapy
  • sarcoma
  • treatment
  • uterine

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