2906 - Preliminary Report on Benefit of Radiotherapy in Women with Uterine Carcinosarcoma
Presenter(s)
R. Zitter1, Y. Che2, C. H. Son3, S. Ackroyd4, G. Fleming5, and Y. Hasan3; 1University of Chicago, Chicago, IL, 2Department of Public Health Sciences, University of Chicago, Chicago, IL, 3Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, IL, 4University of Chicago Department of Gynecologic Oncology, Chicago, IL, 5Department of Medicine, Section of Hematology/Oncology, The University of Chicago Medicine, Chicago, IL
Purpose/Objective(s): As treatment options remain limited in carcinosarcoma, this preliminary analysis explores the impact of radiation therapy (RT) on patient outcomes. Specifically, the effect of RT on progression free survival (PFS) and overall survival (OS).
Materials/Methods: Women treated for uterine carcinosarcoma at a large academic center between the years of 2006 and 2023 were reviewed for clinical outcomes. Patient data were reviewed based on use of post-operative radiation therapy. This included both external beam and brachytherapy. Survival analyses, including log-rank tests and Cox regression models, were used to evaluate PFS and OS. Patients were categorized by stage to assess the impact of radiation treatment at various stages of the disease.
Results: A total of 118 patients (median age 66) with uterine carcinosarcoma were included in the study, 78 of which received RT. Of those who did not receive RT (41), 66% received chemotherapy compared to 90% of those who underwent RT. Patients who received RT demonstrated improved survival outcomes in terms of both PFS and OS compared to those who did not receive RT, particularly in advanced stage. Overall, 5-year PFS for patients receiving RT was 29.9% compared to 12.2% in those without RT (p=0.01). 5-year OS for patients who received RT was 40.3%, compared to 14.6% for those who did not receive RT (p=0.0009). Median OS for the non-RT group was 3.0 years while median OS for RT group was not reached. On stage dependent analysis, significant differences in PFS were found in stage II (n=16, p=0.4) and Stage III (N=49, p=0.01). PFS in Stage I patients approached significance (n=52, p=0.08). For stage IV, only one patient was treated across both subsets. OS was significantly different in stage III patients (5-year OS 37.5% vs 11.7%, p=0.005). Cox regression models adjusted for stage confirmed that RT status was a significant predictor of both PFS and OS outcomes (p =0.02).
Conclusion: On preliminary review, radiation therapy appears to significantly improve survival outcomes for patients with uterine carcinosarcoma, particularly in locally advanced disease. These exploratory findings suggest that RT should be further evaluated as part of the treatment regimen for patients with locally advanced-stage uterine carcinosarcoma to improve both progression-free survival and overall survival. Preliminary results are limited by confounding comorbidities and chemotherapy. Further investigation is needed to confirm these findings and delineate treatment confounders.