Leiomyosarcoma medical therapy: Difference between revisions

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==Chemotherapy==
==Chemotherapy==
*'''Chemotherapy:''' For individuals, particularly those who have locally advanced, metastatic, or recurrent disease, chemotherapy may also be recommended, possibly in combination with surgical procedures and/or radiation.The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Usual drugs include ifosfamide and doxorubicin (Adriamycin).<ref name="pmid29768050">Blay JY (2018) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=29768050 Getting up-to-date in the management of soft tissue sarcoma.] ''Future Oncol'' 14 (10s):3-13. [http://dx.doi.org/10.2217/fon-2018-0074 DOI:10.2217/fon-2018-0074] PMID: [https://pubmed.gov/29768050 29768050]</ref><ref name="pmid5778386">(1969) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=5778386 New antiviral drug.] ''Nature'' 222 (5190):218. PMID: [https://pubmed.gov/5778386 5778386]</ref> Surgical resection of localized disease is a well‐established therapeutic strategy 9. In the event tumors have metastasized, hormonal therapy 10 and cytotoxic chemotherapeutic agents such as gemcitabine 11, docetaxel 12, 13, anthracyclines 14, 15, ifosfamide 16, temozolomide 17, trabectedin 18, 19, eribulin 20, 21, and many other cytotoxic agents provide modest antitumor activity 22. In contrast, novel targeted therapeutic agents have not widely used for the treatment of advanced LMS.
*'''Chemotherapy''' is recommended for individuals who have locally advanced, metastatic, or recurrent disease. Usually in combination with surgical procedures and/or radiation. The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.  
*Most common drugs include ifosfamide and doxorubicin (Adriamycin).<ref name="pmid29768050">Blay JY (2018) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=29768050 Getting up-to-date in the management of soft tissue sarcoma.] ''Future Oncol'' 14 (10s):3-13. [http://dx.doi.org/10.2217/fon-2018-0074 DOI:10.2217/fon-2018-0074] PMID: [https://pubmed.gov/29768050 29768050]</ref><ref name="pmid5778386">(1969) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=5778386 New antiviral drug.] ''Nature'' 222 (5190):218. PMID: [https://pubmed.gov/5778386 5778386]</ref>  
*Surgical resection of localized disease is a mainstay therapeutic strategy.  
*In the event tumors have metastasized or spread beyond uterus and not resectable by surgery, cytotoxic chemotherapeutic agents can be used in combination with radiation therapy.
*Some of these chemotherapeutic agents are gemcitabine, docetaxel, ifosfamide, temozolomide, trabectedin, eribulin.  


==Radiation Therapy==
==Radiation Therapy==

Revision as of 17:16, 8 March 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]

Overview

Uterine leiomyosarcoma (LMS) is the most common sarcoma arising from the uterus and comprises approximately 2% of uterine cancers. Patients diagnosed with LMS have a 5-year overall survival ranging from 25-75% . The primary management of LMS is hysterectomy. Adjuvant pelvic radiotherapy has been shown to improve local control and survival of patients with leiomyosarcoma.

Chemotherapy

  • Chemotherapy is recommended for individuals who have locally advanced, metastatic, or recurrent disease. Usually in combination with surgical procedures and/or radiation. The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.
  • Most common drugs include ifosfamide and doxorubicin (Adriamycin).[1][2]
  • Surgical resection of localized disease is a mainstay therapeutic strategy.
  • In the event tumors have metastasized or spread beyond uterus and not resectable by surgery, cytotoxic chemotherapeutic agents can be used in combination with radiation therapy.
  • Some of these chemotherapeutic agents are gemcitabine, docetaxel, ifosfamide, temozolomide, trabectedin, eribulin.

Radiation Therapy

Radiation therapy: Radiotherapy may be a useful adjunct to improve local control or where a cancer is inoperable due to the specific location or possible progression of the malignancy.It can be used postoperative to help treat known or possible residual disease.Radiation therapy can also be used as a palliative care in cases where extensive metastasis has already occurred.[3]

  • Adjuvant pelvic radiotherapy has been shown by some to improve disease-free survival. [4]
  • Studies had shown that there is a 38% disease-free survival rate in women receiving adjuvant radiotherapy compared with 18% in women receiving surgery alone.[5]

Palliative treatment

  • Palliative treatment: This treatment is used for the patients whose cancer has spread. It may improve the patient's quality of life by controlling the symptoms and complications of this disease.

References

  1. Blay JY (2018) Getting up-to-date in the management of soft tissue sarcoma. Future Oncol 14 (10s):3-13. DOI:10.2217/fon-2018-0074 PMID: 29768050
  2. (1969) New antiviral drug. Nature 222 (5190):218. PMID: 5778386
  3. Reed NS, Mangioni C, Malmström H, Scarfone G, Poveda A, Pecorelli S et al. (2008) Phase III randomised study to evaluate the role of adjuvant pelvic radiotherapy in the treatment of uterine sarcomas stages I and II: an European Organisation for Research and Treatment of Cancer Gynaecological Cancer Group Study (protocol 55874). Eur J Cancer 44 (6):808-18. DOI:10.1016/j.ejca.2008.01.019 PMID: 18378136
  4. Harry, Vanessa N; Narayansingh, Gordon V; Parkin, David E (2007). "Uterine leiomyosarcomas: a review of the diagnostic and therapeutic pitfalls". The Obstetrician & Gynaecologist. 9 (2): 88–94. doi:10.1576/toag.9.2.088.27309. ISSN 1467-2561.
  5. Harry, Vanessa N; Narayansingh, Gordon V; Parkin, David E (2007). "Uterine leiomyosarcomas: a review of the diagnostic and therapeutic pitfalls". The Obstetrician & Gynaecologist. 9 (2): 88–94. doi:10.1576/toag.9.2.088.27309. ISSN 1467-2561.


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