Strahlentherapie des Uterussarkoms

For patients with a leiomyosarcoma or an endometrial stroma sarcoma the use of adjuvant radiation is questionable. Radiation therapy potentially increases the rate and severity of surgical complications in patients with recurrent disease. In patients with a carcinosarcoma postoperative radiation should be considered as adjuvant radiotherapy decreased the rate of local recurrences but not overall survival in retrospective studies and the randomized EORTC study. Therapy-related toxicity is mild and tolerable. A dose of at least 45 Gy conventionally fractionated should be used. A whole abdominal irradiation is not indicated. Due to early distant metastases effective and well tolerable systemic therapies need to be developed. It is absolutely necessary that the extent of surgery should be internationally standardized, a systematic lymphonodectomy should be carried out for carcinosarcomas and molecular prognostic markers should be established in order to estimate risks and prognosis of the patient.