The type of leiomyosarcoma treatment depends on the stage of the cancer and whether leiomyosarcoma has spread to other parts of the body or not. Leiomyosarcoma treatment options include surgery, radiation therapy and chemotherapy.Surgical Leiomyosarcoma Treatment
Surgery is the most common form of leiomyosarcoma treatment. Primary treatment involves removal of the tumor and a margin of adjacent healthy tissue.
Surgical treatment for uterine leiomyosarcoma involves total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH plus BSO), where the entire uterus, fallopian tubes and ovaries are removed. As a precautionary measure, nearby lymph nodes may also be removed during surgery. Despite the invasive nature of surgical treatment for uterine leiomyosarcoma, recurrence rates remain as high as seventy percent.
Adjuvant Radiation Therapy and Chemotherapy
Adjuvant therapy, chemotherapy or radiation therapy combined with surgery, is often used for patients with poor prognosis. Radiation therapy and/or chemotherapy may be administered either before surgery to shrink the tumor, or after surgery to destroy any remaining cancer cells.
Radiation Therapy for Leiomyosarcoma Treatment
Radiation therapy dosages need to be balanced carefully. Optimum levels of radiation will eradicate the tumor, but excessive dosages of radiation therapy might damage the surrounding healthy tissue. Radiation therapy is used routinely to treat more aggressive leiomyosarcomas and as part of a palliative care regimen after a curative attempt in cases where the prognosis is extremely poor.
Chemotherapy treatment for leiomyosarcoma uses anti-cancer drugs to kill the cancerous cells. Chemotherapy is a systemic leiomyosarcoma treatment, where the drugs enter the blood system and travel throughout the body.
Chemotherapy may be taken as a pill or injected into a vein or muscle. In leiomyosarcoma, chemotherapy drugs are often injected directly into the blood vessels at the site of the leiomyosarcoma. This type of leiomyosarcoma treatment is called regional chemotherapy.
Uterine Leiomyosarcoma and Chemotherapy
An article by Martee L. Hensley also in the June 2002 Journal of Clinical Oncology reports best response rates using the drugs doxorubicin combined with either dacarbazine or ifosfamide. Despite these advancements, however, response rates remain around thirty percent, with survival rates of approximately nine to twelve months.
Where the leiomyosarcoma has spread (metastasized) to other parts of the body, palliative chemotherapy, in combination with radiation therapy, may be used as adjuvant therapy to reduce pain. Chemotherapy, in these circumstances, is unlikely to remove the leiomyosarcoma.
Other smaller studies, of patients with advanced stages of leiomyosarcoma, have revealed improved response rates of around fifty percent, using a combination of gemcitabine and docetaxel.
A number of clinical trials are currently exploring new drug treatments for leiomyosarcoma. Ongoing trials include studies of leiomyosarcoma treatments using a combination of temozolomide and thalidomide. Other studies involve drugs such as exatecan, mesylate and perifosine.