Uterine Cancer pp 365-368 | Cite as

Role of Radiation Therapy in Uterine Sarcoma

  • Reena Engineer


Uterine sarcomas are relatively rare tumors with a dismal survival rate of 30–40 %. Fifty percent of women present in FIGO stage I [1]. Most of the tumors spread hematogenously, resulting in an extremely poor prognosis in advanced stages. Even in the early stages (FIGO stage I–II), 35 % of patients fail locally and 65 % fail in distant sites [2, 3]. Radiotherapy to pelvis is given usually as an adjuvant therapy with an aim to decrease local recurrence.


Adjuvant Radiotherapy Figo Stage Uterine Sarcoma Endometrial Stromal Sarcoma Good Local Control 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Livi L, Paiar F, Shah N, Blake P, Villanucci A, Amunni G, et al. Uterine sarcoma: twenty-seven years of experience. Int J Radiat Oncol Biol Phys. 2003;57:1366–73.CrossRefPubMedGoogle Scholar
  2. 2.
    Major FJ, Blessing JA, Silverberg SG, Morrow CP, Creasman WT, Currei JL, et al. Prognostic factors in early stage uterine sarcoma. A Gynecologic Oncology Group study. Cancer. 1993;71:1702–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Chi DS, Mychalczak B, Saigo PE, Recigno J, Brown CL. The role of whole-pelvic irradiation in the treatment of early-stage uterine carcinosarcoma. Gynecol Oncol. 1997;65:493–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Harlow BL, Weiss NS, Lofton S. The epidemiology of sarcomas of the uterus. J Natl Cancer Inst. 1986;76(3):339–402.Google Scholar
  5. 5.
    WHO. Pathology and genetics of tumors of the breast and female genital organs. Lyon: IARC Press; 2003.Google Scholar
  6. 6.
    Benoit L, Arnould L, Cheynel N, Goui S, Collin F, Fraisse J, et al. The role of surgery and treatment trends in uterine sarcoma. Eur J Surg Oncol. 2005;31:434–42.CrossRefPubMedGoogle Scholar
  7. 7.
    Villena-Heinsen C, Diesing C, Fischer D, Griesinger D, Maas G, Diedrich N, et al. Carcinosarcomas – a retrospective analysis of 21 patients. Anticancer Res. 2006;26:4817–23.PubMedGoogle Scholar
  8. 8.
    Pautier P, Rey A, Haie-Meder C, Kerbrat P, Dutel JL, Gesta P, et al. Adjuvant chemotherapy with cisplatin, ifosfamide, and doxorubicin followed by radiotherapy in localized uterine sarcomas: results of a case-control study with radiotherapy alone. Int J Gynecol Cancer. 2004;14:1112–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Odunsi K, Moneke V, Tammela J, Ghamande S, Seago P, Driscoll D, et al. Efficacy of adjuvant CYVADIC chemotherapy in early-stage uterine sarcomas: results of long-term follow-up. Int J Gynecol Cancer. 2004;14:659–64.CrossRefPubMedGoogle Scholar
  10. 10.
    Smith CD, Macdonald OK, Gaffney DK. The impact of adjuvant radiation therapy on survival in women with uterine carcinosarcoma. Radiother Oncol. 2008;88:227–32.CrossRefGoogle Scholar
  11. 11.
    Nemani D, Mitra N, Guo M, et al. Assessing the effects of lymphadenectomy and radiation therapy in patients with uterine carcinosarcoma: a SEER analysis. Gynecol Oncol. 2008;111:82–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Sampath S, Schultheiss TE, Ryu JK, et al. The role of adjuvant radiation in uterine sarcomas. Int J Radiat Oncol Biol Phys. 2010;76:728–34.CrossRefPubMedGoogle Scholar
  13. 13.
    Sorbe B, Paulsson G, Andersson S, Steineck G. A population-based series of uterine carcinosarcomas with long-term follow-up. Acta Oncol. 2013;52(4):759–66.CrossRefPubMedGoogle Scholar
  14. 14.
    Wolfson AH, Brady MF, Rocereto T, et al. A Gynecologic Oncology Group randomized phase III trial of whole abdominal irradiation (WAI) vs. cisplatin-ifosfamide and mesna (CIM) as post-surgical therapy in stage I-IV carcinosarcoma (CS) of the uterus. Gynecol Oncol. 2007;107:177–85.PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Reed NS, Mangioni C, Malmström H, et al. Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organization for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer. 2008;44(6):808–18.CrossRefPubMedGoogle Scholar
  16. 16.
    Callister M, Ramondetta LM, Jhingran A, et al. Malignant mixed Mullerian tumours of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. Int J Radiat Oncol Biol Phys. 2004;58:786–96.CrossRefPubMedGoogle Scholar
  17. 17.
    Galaal K, van der Heijden E, Godfrey K, Naik R, Kucukmetin A, Bryant A, Das N, Lopes AD. Adjuvant radiotherapy and/or chemotherapy after surgery for uterine carcinosarcoma. Cochrane Database Syst Rev. 2013;2:CD006812.PubMedGoogle Scholar
  18. 18.
    Giuntoli 2nd RL, Metzinger DS, DiMarco CS, Cha SS, Sloan JA, Keeney GL, Gostout BS. Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy. Gynecol Oncol. 2003;89:460–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Mahdavi A, Monk BJ, Ragazzo J, Hunter MI, Lentz SE, Vasilev SA, Tewari KS. Pelvic radiation improves local control after hysterectomy for uterine leiomyosarcoma: a 20-year experience. Int J Gynecol Cancer. 2009;19:1080–4.CrossRefPubMedGoogle Scholar
  20. 20.
    Garg G, Shah JP, Liu JR, Bryant CS, Kumar S, Munkarah A, Morris RT. Validation of tumor size as staging variable in the revised international federation of gynecology and obstetrics stage I leiomyosarcoma: a population-based study. Int J Gynecol Cancer. 2010;20:1201–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Gadducci A, Sartori E, Landoni F, et al. Endometrial stromal sarcoma: analysis of treatment failures and survival. Gynecol Oncol. 1996;63:247–53.CrossRefPubMedGoogle Scholar
  22. 22.
    Leath 3rd CA, Huh WK, Hyde Jr J, Cohn DE, Resnick KE, Taylor NP, Powell MA, Mutch DG, Bradley WH, Geller MA, Argenta PA, Gold MA. A multi-institutional review of outcomes of endometrial stromal sarcoma. Gynecol Oncol. 2007;105(3):630–4.CrossRefPubMedGoogle Scholar
  23. 23.
    NCCN guidelines version 1.2015, MS 18–20.Google Scholar

Copyright information

© Springer India 2015

Authors and Affiliations

  1. 1.Department of Radiation OncologyTata Memorial centreMumbaiIndia

Personalised recommendations