Paclitaxel–carboplatin for advanced or recurrent carcinosarcoma of the uterus: the Japan Uterine Sarcoma Group and Tohoku Gynecologic Cancer Unit Study
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  • 作者:Tadao Takano (1)
    Takeo Otsuki (2)
    Hideki Tokunaga (2)
    Masafumi Toyoshima (2)
    Hiroki Utsunomiya (2)
    Satoru Nagase (2)
    Hitoshi Niikura (2)
    Kiyoshi Ito (2)
    Nobuo Yaegashi (2)
    Hidekazu Yamada (3)
    Toru Tase (3)
    Masahiro Kagabu (4)
    Tadahiro Shoji (4)
    Toru Sugiyama (4)
    Naoki Sato (5)
    Toshio Fujimoto (5)
    Yukihiro Terada (5)
    Kenji Nakahara (6)
    Hirohisa Kurachi (6)
    Yoshihito Yokoyama (7)
    Hideki Mizunuma (7)
    Shu Soeda (8)
    Hiroshi Nishiyama (8)
    Takashi Matsumoto (9)
    Shinya Sato (10)
    Muneaki Shimada (10)
    Junzo Kigawa (10)
  • 关键词:Carcinosarcoma of the uterus ; Paclitaxel + carboplatin ; Prospective multi ; institutional study
  • 刊名:International Journal of Clinical Oncology
  • 出版年:2014
  • 出版时间:December 2014
  • 年:2014
  • 卷:19
  • 期:6
  • 页码:1052-1058
  • 全文大小:186 KB
  • 参考文献:1. Brooks SE, Zhan M, Cote T et al (2004) Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989-999. Gynecol Oncol 93:204-08 CrossRef
    2. Iwasa Y, Haga H, Konishi I et al (1998) Prognostic factors in uterine carcinosarcoma: a clinicopathologic study of 25 patients. Cancer 82:512-19 CrossRef
    3. Szukala SA, Marks JR, Burchette JL et al (1999) Co-expression of p53 by epithelial and stromal elements in carcinosarcoma of the female genital tract: an immunohistochemical study of 19 cases. Int J Gynecol Cancer 9:131-36 CrossRef
    4. McCluggage WG (2002) Uterine carcinosarcomas (malignant mixed Mullerian tumors) are metaplastic carcinomas. Int J Gynecol Cancer 12:687-90 CrossRef
    5. Akahira J, Tokunaga H, Toyoshima M et al (2006) Prognoses and prognostic factors of carcinosarcoma, endometrial stromal sarcoma and uterine leiomyosarcoma: a comparison with uterine endometrial adenocarcinoma. Oncology 71:333-40 CrossRef
    6. Price FV, Edwards RP, Kelley JL et al (1997) A trial of outpatient paclitaxel and carboplatin for advanced, recurrent, and histologic high-risk endometrial carcinoma: preliminary report. Semin Oncol 24[5 Suppl 15]:S15-78–S15-82
    7. Vasuratna A, Kudelka AP, Edwards CL et al (1998) Prolonged remission of endometrial cancer with paclitaxel and carboplatin. Anticancer Drugs 9:283-85 CrossRef
    8. Szlosarek PW, Lofts FJ, Pettengell R et al (2000) Effective treatment of a patient with a high-grade endometrial stromal sarcoma with an accelerated regimen of carboplatin and paclitaxel. Anticancer Drugs 11:275-78 CrossRef
    9. Sutton GP, Blessing JA, Photopulos G et al (1989) Phase II experience with ifosfamide/mesna in gynecologic malignancies: preliminary report of Gynecologic Oncology Group studies. Semin Oncol 16:68-2
    10. Sutton GP, Blessing JA, Rosenshein N et al (1989) Phase II trial of ifosfamide and mesna in mixed mesodermal tumors of the uterus (a Gynecologic Oncology Group study). Am J Obstet Gynecol 161:309-12 CrossRef
    11. Sutton GP, Blessing JA, Photopulos G et al (1990) Early phase II Gynecologic Oncology Group experience with ifosfamide/mesna in gynecologic malignancies. Cancer Chemother Pharmacol 26[Suppl]:S55–S58 CrossRef
    12. Sutton GP, Blessing JA, Homesley HD et al (1994) A phase II trial of ifosfamide and mesna in patients with advanced or recurrent mixed mesodermal tumors of the ovary previously treated with platinum-based chemotherapy: a Gynecologic Oncology Group study. Gynecol Oncol 53:24-6 CrossRef
    13. Muss HB, Bundy B, DiSaia PJ (1985) Treatment of recurrent or advanced uterine sarcoma. A randomized trial of doxorubicin versus doxorubicin and cyclophosphamide (a phase III trial of the Gynecologic Oncology Group). Cancer 55:1648-653 CrossRef
    14. Omura GA, Blessing JA, Major F (1985) A randomized clinical trial of adjuvant adriamycin in uterine sarcomas: a Gynecologic Oncology Group Study. J Clin Oncol 3:1240-245
    15. Thigpen JT, Blessing JA, Orr JW et al (1986) Phase II trial of cisplatin in the treatment of patients with advanced or recurrent mixed mesodermal sarcomas of the uterus: a Gynecologic Oncology Group Study. Cancer Treat Rep 70:271-74
    16. Thigpen JT, Blessing JA, Beecham J et al (1991) Phase II trial of cisplatin as first-line chemotherapy in patients with advanced or recurrent uterine sarcomas: a Gynecologic Oncology Group study. J Clin Oncol 9:1962-966
    17. Curtin JP, Blessing JA, Soper JT et al (2001) Paclitaxel in the treatment of
  • 作者单位:Tadao Takano (1)
    Takeo Otsuki (2)
    Hideki Tokunaga (2)
    Masafumi Toyoshima (2)
    Hiroki Utsunomiya (2)
    Satoru Nagase (2)
    Hitoshi Niikura (2)
    Kiyoshi Ito (2)
    Nobuo Yaegashi (2)
    Hidekazu Yamada (3)
    Toru Tase (3)
    Masahiro Kagabu (4)
    Tadahiro Shoji (4)
    Toru Sugiyama (4)
    Naoki Sato (5)
    Toshio Fujimoto (5)
    Yukihiro Terada (5)
    Kenji Nakahara (6)
    Hirohisa Kurachi (6)
    Yoshihito Yokoyama (7)
    Hideki Mizunuma (7)
    Shu Soeda (8)
    Hiroshi Nishiyama (8)
    Takashi Matsumoto (9)
    Shinya Sato (10)
    Muneaki Shimada (10)
    Junzo Kigawa (10)

    1. Clinical Research, Innovation, and Education Center, Tohoku University Hospital (CRIETO), 1-1 Seiryo-machi, Aoba Ward, Sendai, Miyagi, 980-8574, Japan
    2. Department of Gynecology, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
    3. Department of Gynecology, Miyagi Cancer Center, Natori, Miyagi, Japan
    4. Department of Obstetrics and Gynecology, Iwate Medical University, Morioka, Iwate, Japan
    5. Department of Obstetrics and Gynecology, Akita University, Akita City, Akita, Japan
    6. Department of Obstetrics and Gynecology, Yamagata University, Yamagata City, Yamagata, Japan
    7. Department of Obstetrics and Gynecology, Hirosaki University, Hirosaki, Aomori, Japan
    8. Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima City, Fukushima, Japan
    9. Department of Gynecology, Shikoku Cancer Center, Matsuyama, Ehime, Japan
    10. Department of Obstetrics and Gynecology, Tottori University, Yonago, Tottori, Japan
  • ISSN:1437-7772
文摘
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 48-7) 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-). 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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