BACKGROUND: Patients with large, high-grade extremity and truncal soft tissue sarcomas (STS) are at considerable risk for recurrence. A regimen of pre-operative chemotherapy consisting of mesna, adriamycin, ifosfamide and dacarbazine (MAID), interdigitated with radiotherapy (RT), followed by resection and post-operative chemotherapy with or without RT, has demonstrated high rates of local and distant control. The goal of this study is to assess outcomes in a recent cohort of patients treated on this regimen. METHODS: We retrospectively reviewed records of 66 consecutive patients with STS of the extremity or trunk who were treated with the aforementioned regimen from May 2000 to April 2011. Clinicopathologic characteristics and patient outcomes were analysed. RESULTS: Sixty-six patients were analysed and were equally divided between grade 2 and 3 tumours. Margins were negative in 57 (89%) patients and positive in seven (11%) patients. At a median follow-up of 46 months, there were six (9%) locoregional and 20 (30%) distant recurrences. The locoregional and distant 5-year recurrence-free survival (RFS) rates were 91% and 64%, respectively. The 5-year overall (OS) and disease-specific survival rates were 86% and 89%, respectively. There were no treatment-related deaths or secondary myelodysplasias. Thirty-four (52%) patients had grade 3 or 4 acute haematologic chemotherapy-related toxicity. There were no statistically significant predictors of OS or RFS. CONCLUSIONS: For a contemporary cohort of patients with high-risk extremity and truncal STS, a regimen of neoadjuvant chemoradiotherapy and surgery continues to result in high rates of survival with tolerable short- and long-term toxicity.
BACKGROUND:Patients with large, high-grade extremity and truncal soft tissue sarcomas (STS) are at considerable risk for recurrence. A regimen of pre-operative chemotherapy consisting of mesna, adriamycin, ifosfamide and dacarbazine (MAID), interdigitated with radiotherapy (RT), followed by resection and post-operative chemotherapy with or without RT, has demonstrated high rates of local and distant control. The goal of this study is to assess outcomes in a recent cohort of patients treated on this regimen. METHODS: We retrospectively reviewed records of 66 consecutive patients with STS of the extremity or trunk who were treated with the aforementioned regimen from May 2000 to April 2011. Clinicopathologic characteristics and patient outcomes were analysed. RESULTS: Sixty-six patients were analysed and were equally divided between grade 2 and 3 tumours. Margins were negative in 57 (89%) patients and positive in seven (11%) patients. At a median follow-up of 46 months, there were six (9%) locoregional and 20 (30%) distant recurrences. The locoregional and distant 5-year recurrence-free survival (RFS) rates were 91% and 64%, respectively. The 5-year overall (OS) and disease-specific survival rates were 86% and 89%, respectively. There were no treatment-related deaths or secondary myelodysplasias. Thirty-four (52%) patients had grade 3 or 4 acute haematologic chemotherapy-related toxicity. There were no statistically significant predictors of OS or RFS. CONCLUSIONS: For a contemporary cohort of patients with high-risk extremity and truncal STS, a regimen of neoadjuvant chemoradiotherapy and surgery continues to result in high rates of survival with tolerable short- and long-term toxicity.
Authors: J C Yang; A E Chang; A R Baker; W F Sindelar; D N Danforth; S L Topalian; T DeLaney; E Glatstein; S M Steinberg; M J Merino; S A Rosenberg Journal: J Clin Oncol Date: 1998-01 Impact factor: 44.544
Authors: William G Kraybill; Jonathon Harris; Ira J Spiro; David S Ettinger; Thomas F DeLaney; Ronald H Blum; David R Lucas; David C Harmon; G Douglas Letson; Burton Eisenberg Journal: J Clin Oncol Date: 2006-02-01 Impact factor: 44.544
Authors: S F Stinson; T F DeLaney; J Greenberg; J C Yang; M H Lampert; J E Hicks; D Venzon; D E White; S A Rosenberg; E J Glatstein Journal: Int J Radiat Oncol Biol Phys Date: 1991-11 Impact factor: 7.038
Authors: Thomas F Delaney; Lucyna Kepka; Saveli I Goldberg; Francis J Hornicek; Mark C Gebhardt; Sam S Yoon; Dempsey S Springfield; Kevin A Raskin; David C Harmon; David G Kirsch; Henry J Mankin; Andrew E Rosenberg; G Petur Nielsen; Herman D Suit Journal: Int J Radiat Oncol Biol Phys Date: 2007-04-01 Impact factor: 7.038
Authors: Akshay Tiwari; Swati Shah; Ashwani Kumar Sharma; Sandeep Mehta; Ullas Batra; S K Sharma; A K Dewan Journal: Indian J Surg Oncol Date: 2016-11-02
Authors: J Attal; B Cabarrou; T Valentin; J P Nesseler; E Stoeckle; A Ducassou; T Filleron; S Le Guellec; B Boulet; G Vogin; G Ferron; E Cohen-Jonathan Moyal; M Delannes; C Chevreau Journal: Strahlenther Onkol Date: 2021-10-21 Impact factor: 3.621
Authors: Amani Arthur; Edward W Johnston; Jessica M Winfield; Matthew D Blackledge; Robin L Jones; Paul H Huang; Christina Messiou Journal: Front Oncol Date: 2022-07-01 Impact factor: 5.738
Authors: Rima Ahmad; Alex Jacobson; Francis Hornicek; Alex B Haynes; Edwin Choy; Gregory Cote; G Petur Nielsen; Yen-Lin Chen; Thomas F DeLaney; John T Mullen Journal: Oncologist Date: 2016-07-20
Authors: John T Mullen; Francis J Hornicek; David C Harmon; Kevin A Raskin; Yen-Lin Chen; Jackie Szymonifka; Beow Y Yeap; Edwin Choy; Thomas F DeLaney; G Petur Nielsen Journal: Cancer Date: 2014-07-31 Impact factor: 6.860
Authors: Fien Hoefkens; Charlotte Dehandschutter; Johan Somville; Paul Meijnders; Dirk Van Gestel Journal: Radiat Oncol Date: 2016-10-12 Impact factor: 3.481