F Stubbe1, A Agaimy2, O Ott1, S Lettmaier1, N Vassos3, R Croner3, W Hohenberger3, R Fietkau1, S Semrau4. 1. Department of Radiation Oncology, University of Erlangen-Nurnberg, Universitätsstraße 27, 91054 Erlangen, Germany. 2. Pathology Institute, University of Erlangen-Nurnberg, Krankenhausstraße 8-10, 91054 Erlangen, Germany. 3. Department of Surgery, University of Erlangen-Nurnberg, Krankenhausstraße 12, 91054 Erlangen, Germany. 4. Department of Radiation Oncology, University of Erlangen-Nurnberg, Universitätsstraße 27, 91054 Erlangen, Germany. Electronic address: sabine.semrau@uk-erlangen.de.
Abstract
PURPOSE: There is a sound theoretical basis but little clinical evidence substantiating the benefits of concurrent chemoradiotherapy with two-drug chemotherapy for locally advanced soft tissue sarcomas. Our five-year data on the feasibility and effectiveness of neoadjuvant chemoradiotherapy with systemically effective doses of adriamycin and ifosfamide combined is presented here. PATIENTS AND METHODS: Between 2000 and 2011, 53 patients with UICC (2010) stage I (n=1, 1.9%), II (n=12, 22.7%) or III (n=40, 75.5%) nonmetastatic soft tissue sarcoma received neoadjuvant chemoradiotherapy with ifosfamide (1.5 g/m(2)/day, d1-5, q28) and doxorubicin (50mg/m(2)/day, d3, q28) plus concurrent radiotherapy with a target dose of 50-64 Gy (median 60 Gy). The treatment of 34 patients (64.2%) was combined with hyperthermia. RESULTS: At five years, the local control rate was 89.9% (± 5.7%), distant metastasis-free survival 66.6% (± 7.6%), and survival 83.3% (± 6%). The R0 resection rate was 81.1%. Radiotherapy was completed as planned in all patients and chemotherapy in 42/53 (70.2%). Grades III (n=21, 29.6%) and IV (n=18, 34%) leukopenia was the main acute adverse event. All acute and chronic non-hematologic toxicities were moderate. CONCLUSION: Neoadjuvant chemoradiotherapy for soft tissue sarcoma is associated with good feasibility, manageable acute and late toxicities, and high local efficacy.
PURPOSE: There is a sound theoretical basis but little clinical evidence substantiating the benefits of concurrent chemoradiotherapy with two-drug chemotherapy for locally advanced soft tissue sarcomas. Our five-year data on the feasibility and effectiveness of neoadjuvant chemoradiotherapy with systemically effective doses of adriamycin and ifosfamide combined is presented here. PATIENTS AND METHODS: Between 2000 and 2011, 53 patients with UICC (2010) stage I (n=1, 1.9%), II (n=12, 22.7%) or III (n=40, 75.5%) nonmetastatic soft tissue sarcoma received neoadjuvant chemoradiotherapy with ifosfamide (1.5 g/m(2)/day, d1-5, q28) and doxorubicin (50mg/m(2)/day, d3, q28) plus concurrent radiotherapy with a target dose of 50-64 Gy (median 60 Gy). The treatment of 34 patients (64.2%) was combined with hyperthermia. RESULTS: At five years, the local control rate was 89.9% (± 5.7%), distant metastasis-free survival 66.6% (± 7.6%), and survival 83.3% (± 6%). The R0 resection rate was 81.1%. Radiotherapy was completed as planned in all patients and chemotherapy in 42/53 (70.2%). Grades III (n=21, 29.6%) and IV (n=18, 34%) leukopenia was the main acute adverse event. All acute and chronic non-hematologic toxicities were moderate. CONCLUSION: Neoadjuvant chemoradiotherapy for soft tissue sarcoma is associated with good feasibility, manageable acute and late toxicities, and high local efficacy.
Authors: Riikka Nevala; Erkki Tukiainen; Maija Tarkkanen; Tom Böhling; Carl Blomqvist; Mika Sampo Journal: Sci Rep Date: 2019-05-13 Impact factor: 4.379
Authors: A Willner; K Fechner; A Agaimy; F Haller; M Eckstein; O J Ott; F Putz; U S Gaipl; S Kersting; N Meidenbauer; R Grützmann; R Fietkau; S Semrau Journal: Strahlenther Onkol Date: 2021-11-04 Impact factor: 3.621