A preliminary study of a combination chemotherapy with ifosfamide, adriamycin and cisplatin for endometrial carcinoma

Seven patients with uterine endometrial carcinoma received a postoperative combination chemotherapy with ifosfamide (1g/m2) daily for 5 days, and adriamycin (50mg/m2) and cisplatin (50mg/m2) on day 1 (IAP). All except one patient with the disease without myometrial invasion received 5 courses or more of IAP treatment. Of four patients with measurable disease, three achieved complete response (CR) and the other patient obtained partial response (PR), indicating a 100% response rate. In the PR case, the patient had previously been treated by radiation treatment for cervical cancer, and the histology of the tumor was papillary serous adenocarcinoma, a malignant variant of endometrial cancer. Six patients underwent second look operation following the planned IAP treatment courses, and the operation confirmed no pathological evidence of disease in any, although in one disease recurred 7 months after the second laparotomy. Side effects were remarkable, including an 87% incidence of grade 4 leucopenia. However, the patients recovered spontaneously from the hematologic toxicity within 3 weeks of treatment. Other toxic effects including central nervous system toxicity were controllable and acceptable. The results indicated that IAP combination therapy was feasible and promising in the management of patients with endometrial carcinoma.