A randomized study of adriamycin with and without dimethyl triazenoimidazole carboxamide in advanced uterine sarcomas

Authors

  • G. A. Omura MD,

    Corresponding author
    1. Professor of Medicine, University of Alabama in Birmingham, Birmingham, Alabama
    • GOG Headquarters Office, Suite 430, 1234 Market Street, Philadelphia, PA 19107
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  • F. J. Major MD,

    1. Associate Clinical Professor of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Director, Gynecology Tumor Service, Denver General Hospital, Denver, Colorado
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  • J. A. Blessing PhD,

    1. Group Statistician, Gynecologic Oncology Group, Cancer Research Scientist V, Roswell Park Memorial Institute, Buffalo, New York
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  • T. V. Sedlacek MD,

    1. Professor and Chairman, Department of Obstetrics and Gynecology, Director, Gynecologic Oncology, Hahnemann Medical College, Philadelphia, Pennsylvania
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  • J. T. Thigpen MD,

    1. Associate Professor of Medicine and Assistant Professor of Obstetrics and Gynecology, Division of Medical Oncology, Departments of Medicine and Obstetrics and Gynecology, University of Mississippi School of Medicine, Jackson, Mississippi
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  • W. T. Creasman MD,

    1. Director, Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina
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  • R. J. Zaino MD

    1. Assistant Professor, Department of Pathology, M. S. Hershey Medical Center of Pennsylvania State University, Hershey, Pennsylvania
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Abstract

Various drug combinations including Adriamycin have been tested in soft tissue sarcomas, but optimal treatment remains unclear. We have evaluated Adriamycin with and without dimethyl-triazeno-imid-azole-carboxamide (DTIC) in the treatment of Stage III or IV and recurrent sarcomas of the uterus. Two hundred and forty cases of these rare tumors were evaluable. Of 146 evaluable patients with measurable disease, 13/80 (16.3%) of Adriamycin-treated patients and 16/66 (24.2%) of patients receiving the combination showed an objective response (P > 0.05). Lung metastases responded more frequently (P = 0.04) to combination therapy, but there was no survival advantage. For patients with nonmeasurable disease the progression-free interval was similar (10.0 months for Adriamycin and 8.0 months for the combination). Leiomyosarcomas had a significantly longer survival than other cell types (12.1 versus 6.0 months, P < 0.001) but there was no advantage for either regimen. There was a suggestion that heterologous mixed mesodermal sarcomas were more responsive to the combination (27.3 versus 8.7%). The addition of DTIC produced significantly more hematologic and gastrointestinal toxicity. Other Adriamycin combinations should be evaluated in uterine sarcomas.

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