Hypofractionated Accelerated Chemo-radiotherapy (Chemo-HypoAR) With Cisplatin and Liposomal Doxorubicin for the Treatment of Patients With Uterine Sarcomas

BACKGROUND/AIM: Uterine sarcoma is an aggressive tumor associated with poor survival, compared to endometrioid carcinoma. Postoperative local radiotherapy and chemotherapy are controversial. PATIENTS AND METHODS: We report a retrospective analysis of 14 patients with uterine homologous type carcinosarcoma (9 patients) or leiomyosarcoma (5 patients), treated with postoperative 3D-conformal accelerated hypofractionated radiotherapy (2.7 Gy/fraction for 14 fractions followed by one fraction of 6-8 Gy dose to the vagina). Chemotherapy with cisplatin (50 mg/m2) and liposomal doxorubicin (20 mg/m2), was also administered bi-weekly for two cycles before and for three cycles during radiotherapy. RESULTS: Chemotherapy induced only grade 1 neutropenia or anemia in 4/14 (28.5%) and 5/14 (35.7%) of patients, respectively. Two patients (2/14, 14.2%) interrupted their radiotherapy for one and two weeks, respectively, due to grade II persistent diarrhea. Within a median of 58 months (range=8-137 months) of follow-up, none of the patients presented with loco-regional relapse. Two patients developed distant metastasis. CONCLUSION: Concurrent hypofractionated and accelerated chemo-radiotherapy (chemo-HypoAR) is feasible and provides excellent survival figures.