Table of Contents
Journal of Radiotherapy
Volume 2014, Article ID 124149, 8 pages
http://dx.doi.org/10.1155/2014/124149
Research Article

Uterine Carcinosarcoma Confined to the Pelvis: A Retrospective Review and Outcome Analysis

1Department of Radiation Oncology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
2Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
3Department of Radiation Oncology, Hospital of the University of Pennsylvania, 3400 Civic Center Boulevard, PCAM/TRC 4 West, Philadelphia, PA 19104, USA
4Department of Radiation Oncology, West Virginia University Healthcare, 1 Medical Center Drive, Morgantown, WV 26506, USA

Received 8 October 2013; Accepted 1 February 2014; Published 11 March 2014

Academic Editor: Zsuzsanna Kahán

Copyright © 2014 Hualei Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. We compared the treatments of uterine carcinosarcoma at our institution and evaluated their impact on survival. Methods. A retrospective analysis was performed on 60 eligible patients with carcinosarcoma limited to the pelvis. Subjects were divided into four categories: surgery, surgery plus chemotherapy, surgery plus radiation therapy, and a combination of surgery, chemotherapy, and RT. The most commonly used chemotherapy was cisplatin and/or carboplatin and taxol. Radiotherapy included external beam radiation therapy (EBRT) alone or with high dose rate (HDR) brachytherapy or HDR brachytherapy alone. Survival probability data were computed using the Kaplan-Meier method. The differences between groups were compared using the log-rank test. Results. The combination of surgery and radiation therapy with or without chemotherapy is seen to improve overall survival (OS) compared to surgery alone and , resp.). Brachytherapy involving three HDR vaginal cylinder fractions shows an equally effective reduction in local recurrence compared to EBRT. Conclusion. Our study of a relatively large number of carcinosarcoma patients suggests that adjuvant radiation therapy improves OS compared to surgery alone. Brachytherapy with 3 HDR vaginal cylinder fractions is preferred because of its time-saving, better tolerance, low toxicity and equivalent OS, and local control compared to EBRT.