A retrospective review of metastatic or recurrent uterine sarcomas treated with ifosfamide and doxorubicin (IMA)

The prognosis of metastatic uterine sarcoma is poor with median survival reported between 4 to 26 months. We evaluated the efficacy and toxicity of ifosfamide (I), mesna (M) and doxorubicin (A) (IMA) chemotherapy regimen retrospectively in patients with metastatic or recurrent uterine sarcomas. Forty-two patients were enrolled in this study. The median age was 53 years (range, 18-72). Thirty-seven patients were assessable for response and survival; forty patients were assessable for toxicity. A total of 162 cycles of chemotherapy were introduced and for each patient and median number of chemotherapy cycles were 4 (range, 1-6). We observed complete response (CR) in 3 patients; partial response (PR) in 14 patients. Objective RR was 46% (95% CI, 30% to 62%). The median progression-free survival time of the responders was 8.0 months (range, 4-35). The median progression-free survival time of all patients was 5.0 months. Febrile neutropenia was encountered in 6 patients. Dose modifications were required in 4 patients due to myelotoxicity. Central nervous system (CNS) toxicity was observed in three patients. IMA regimen has moderate anti-tumor activity (46%) with acceptable toxicity in patients with recurrent or metastatic uterine sarcomas.