Chemotherapy for Uterine Sarcomas: A Review

Uterine sarcomas are relatively rare tumors, constituting only 8%-10% of all uterine malignancies. Its three most common histologic variants are carcinosarcoma (CS), leiomyosarcoma (LMS), and endometrial stromal sarcoma (ESS). Because of its frequent resistance to existing chemotherapeutic drugs (caused by several mechanisms), standard chemotherapeutic regimens have not yet been established. Presently, CSs are treated in the same way as high-grade endometrioid endometrial carcinomas. A combination of carboplatin and paclitaxel is the most commonly used adjuvant therapy regimen in advanced or recurrent CS. For LMS, the key drugs are doxorubicin, ifosfamide, gemcitabine, and docetaxel. These drugs are used as single agents or in combination for the treatment of patients with advanced or recurrent LMS. For ESS treatment, hormonal agents have been used because ESS expresses estrogen and progesterone receptors. Because of its rarity, well-designed random controlled trials are required for future investigations of the efficacy of chemotherapy for patients with uterine sarcoma.

Keywords: Carcinosarcoma, Chemotherapy, Endometrial stromal sarcoma, Leiomyosarcoma, Uterine sarcoma.