MALIGNANT UTERINE SMOOTH-MUSCLE TUMORS - ROLE OF ETOPOSIDE, CISPLATIN, AND DOXORUBICIN (EPA) CHEMOTHERAPY

Background: Nearly 80% of patients with malignant uterine smooth muscl e tumor will suffer local relapse and/or distant metastases after init ial surgical resection. There is no convincing evidence that the addit ion of pelvic radiation improves the outcome. However, adjuvant chemot herapy might be an appropriate therapeutic modality. Methods: Between 1986 and 199 1, 13 consecutive patients with malignant uterine smooth muscle tumors were treated at Yale-New Haven Hospital with a combinati on chemotherapy containing etoposide 100 mg/M(2) on days 1 and 2, cisp latin 50 mg/M(2) on day 1, and doxorubicin 50 mg/M(2) on day 1, repeat ed every 28 days. Six patients had Stage I disease, one patient had St age LII disease, and six patients had Stage IV disease. The number of cycles ranged from 2 to 9. Results: The median follow-up was 30 months (range 4-81). The mean overall survival for the group was 43.1 +/- 6. 7 months, with the progression-free interval of 25.5 +/- 8.0 months. O f the seven patients with evaluable disease, one patient had complete response and one had partial response (total response rate of 28.6%). Of the six patients treated adjuvantly, three recurred at 9, 33, and 5 9 months (recurrence rate of 50%). Conclusions: We conclude that this combination has only modest activity against malignant uterine smooth muscle tumors at the schedule and doses tested. (C) 1996 Wiley-Liss, I nc.