Cisplastin (C) And Ifosfamide (I) Chemotherapy With Vaginal Cuff Brachytherapy (Vcbt) For Treatment Of Uterine Carcinosarcoma

5123 Background: Uterine carcinosarcoma is an uncommon and aggressive type of uterine cancer with a poor prognosis. The purpose of this retrospective study is to report the efficacy and tolerability of C and I chemotherapy with VCBT in the treatment of uterine carcinosarcoma at Yale-New Haven Hospital (YNHH). Methods: Patients (pts) diagnosed with uterine carcinosarcoma in years 1996-2008 were identified through the Tumor Board Registry of YNHH. Demographic and clinical data including stage, histology, grade, dose, cycles, need for dose reduction, toxicities, comorbidities, progression-free (PFS) and overall survival (OS) were obtained. Pts received C 40 mg/m2 on day 1 and I 1.2 mg/m2 daily on days 1 to 4 with Mesna every 4 weeks for 6 cycles. High-dose rate intracavitary VCBT was delivered with a vaginal cylinder. A total of 14 Gy was delivered in 2 fractions of 7 Gy each prescribed to a depth of 0.5 cm. The two fractions were administered 2 weeks apart in cycle 1 and 2. Results: A total of 29 pts treated with C and I were identified, and 23 of 29 pts received VCBT. Median age of pts is 65 (range 40-82). Sixteen pts (54.8%) with stage I/II, 8 (27.6%) stage III, and 5 (17.2%) with stage IV disease. Eighteen (62%) pts completed C and I without a dose reduction, 6 required a dose reduction, while 5 required early termination (3 of 5 pts completed < 5 cycles). At median follow up of 19 month (range 6-73), disease progression occurred in 9 pts (31%) and death occurred in 7 pts. With VCBT, no isolated vaginal failures were identified. Documented grade 3 toxicities included neutropenia (17%), anemia (14%), thrombocytopenia (3%), neurotoxicity (7%), fatigue (7%), nausea/vomiting (3%), hematuria (3%), cardiac toxicity (3%) and dyspnea (3%). Two pts (7%) had grade 4 neutropenia. Conclusions: C and I chemotherapy with VCBT represents a well tolerated regimen with promising activity for uterine carcinosarcoma. The addition of VCBT results in excellent local response. No significant financial relationships to disclose.