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01.12.2014 | Original Article | Ausgabe 6/2014

International Journal of Clinical Oncology 6/2014

Paclitaxel–carboplatin for advanced or recurrent carcinosarcoma of the uterus: the Japan Uterine Sarcoma Group and Tohoku Gynecologic Cancer Unit Study

Zeitschrift:
International Journal of Clinical Oncology > Ausgabe 6/2014
Autoren:
Tadao Takano, Takeo Otsuki, Hideki Tokunaga, Masafumi Toyoshima, Hiroki Utsunomiya, Satoru Nagase, Hitoshi Niikura, Kiyoshi Ito, Nobuo Yaegashi, Hidekazu Yamada, Toru Tase, Masahiro Kagabu, Tadahiro Shoji, Toru Sugiyama, Naoki Sato, Toshio Fujimoto, Yukihiro Terada, Kenji Nakahara, Hirohisa Kurachi, Yoshihito Yokoyama, Hideki Mizunuma, Shu Soeda, Hiroshi Nishiyama, Takashi Matsumoto, Shinya Sato, Muneaki Shimada, Junzo Kigawa

Abstract

Background

Paclitaxel and carboplatin (PC) have shown antitumor activity in carcinosarcoma of the uterus (CS). The purpose of this prospective multi-institutional study was to determine the response rate (RR), progression-free survival (PFS) and overall survival (OS) and to assess the toxicity of paclitaxel and carboplatin in patients with CS.

Methods

We conducted a phase II study in which patients were administered paclitaxel 175 mg/m2 over a 3-h period followed by carboplatin (area under the serum concentration–time curve = 6) intravenously over a 30-min period on day 1 of each treatment cycle (3 weeks) until disease progression or adverse effects prohibited further therapy. Eligible patients had histologically confirmed, advanced stage (III or IV), persistent or recurrent measurable disease, and no prior chemotherapy.

Results

Six patients were enrolled between February 2006 and April 2009. The median age of the patients was 61 (range 48–77) years; one patient was stage IIIC (17 %) and five were stage IVB (83 %). Three patients (50 %) (1 at stage IIIC and 2 at stage IVB) received total abdominal hysterectomy plus bilateral salpingo-oophorectomy as part of the initial treatment; five (83 %) had homologous tumors and one (17 %) had a heterologous tumor. The median cycle number administered was 4.8 (range 2–7). The RR was 66.7 % (complete response, 2; partial response, 2); the PFS was 9.1 months and OS was not reached. The frequently observed Grade 4 toxicities were neutropenia (3 patients, 50 %). Manageable neutropenic sepsis developed in one patient.

Conclusion

This is the first prospective multi-institutional study in Asia showing that PC may be effective and tolerable for the treatment of advanced or recurrent CS.

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