TOXICITY OF CHEMOTHERAPEUTICAL PROTOCOLS IN THE TREATMENT OF UTERINE SARCOMAS (VINCRISTINE, ACTINOMYCIN-D, CYCLOPHOSPHAMIDE VAC VERSUS IFOSFAMIDE)

Objective: Uterine sarcomas are rare tumors which account for 1% of al l genital tract malignancies. They have a poor prognosis with an overa ll survival of under 50% at 2 years. The benefit of chemotherapy is un clear and different chemotherapy protocols are used for the treatment of uterine sarcomas. But there is little experience about their toxici ty because of the limited case series. So we compared VAC protocol and ifosfamide for toxic effects. Material and Method: We reviewed 13 cas es which were diagnosed as uterine sarcomas and treated with surgery p lus chemotherapy at The Department of Obstetrics and Gynecology, Akden iz University School of Medicine from 1990 to 1995. Data were obtained from patient files. Results: Mean age was 55.7 (range 38-70), 7 (53.8 %) patients had malignant mixed mullerian tumors and 6 (46.1) had leio myosarcomas. A total of 32 courses of chemotherapy were given -20 ifos famide and 12 VAC therapy. Leucopenia, hepatic dysfunction and periphe ral neuropathy were more frequent in the VAC group as 75%, 16.6%, vers us 30%, 0%, 0% in the ifosfamide group respectively. However, urotheli al toxicity (35%) was more common in the ifosfamide group. Conclusion: VAC protocol is more toxic for the liver, hematopoietic and periphera l neurologic system. On the other hand the major toxicity of ifosfamid e was on the urinary tract. Ifosfamide may be a good choice with less toxicity than VAC therapy in the treatment of uterine sarcomas.