BACKGROUND: Frequently, soft tissue sarcomas (STS) do not present until they are large, thus making local control difficult. Consequently, different methods of preoperative cytoreduction should be evaluated. METHODS: This study evaluated a 10-day preoperative regimen of intraarterial doxorubicin (10 mg/m2/d), with concomitant radiation therapy (25 Gy), administered to 55 adult patients with either Stage T2 (n = 41) or distal Stage T1 (n = 14) STS. Seven of the tumors were low grade. All patients were treated by the Division of Surgical Oncology at the University of Illinois between 1978-1991. RESULTS: This regimen was successful and obviated the need for amputation in 47 patients who underwent wide soft tissue excision, an initial limb-salvage rate of 87%. Complications related to the therapy occurred in 26% of patients, which resulted in additional operative procedures in 7%. The mean follow-up time was 94 months. The 5-year overall survival rate was 69%, with a disease-free survival rate of 51%. Local control was unsuccessful in 15% of the patients. Three additional patients required amputation for recurrent disease (n = 2) or complications of therapy (n = 1), resulting in an ultimate limb-salvage rate of 81%. CONCLUSIONS: The long-term results of this preoperative protocol for adults with limb-threatening STS appears to justify the utilization of a multimodality approach. This preoperative regimen was useful in minimizing limb loss in patients with limb-threatening STS. However, intraarterial doxorubicin administration is associated with significant morbidity, and its role in multimodality treatment of STS requires further clarification.
BACKGROUND: Frequently, soft tissue sarcomas (STS) do not present until they are large, thus making local control difficult. Consequently, different methods of preoperative cytoreduction should be evaluated. METHODS: This study evaluated a 10-day preoperative regimen of intraarterial doxorubicin (10 mg/m2/d), with concomitant radiation therapy (25 Gy), administered to 55 adult patients with either Stage T2 (n = 41) or distal Stage T1 (n = 14) STS. Seven of the tumors were low grade. All patients were treated by the Division of Surgical Oncology at the University of Illinois between 1978-1991. RESULTS: This regimen was successful and obviated the need for amputation in 47 patients who underwent wide soft tissue excision, an initial limb-salvage rate of 87%. Complications related to the therapy occurred in 26% of patients, which resulted in additional operative procedures in 7%. The mean follow-up time was 94 months. The 5-year overall survival rate was 69%, with a disease-free survival rate of 51%. Local control was unsuccessful in 15% of the patients. Three additional patients required amputation for recurrent disease (n = 2) or complications of therapy (n = 1), resulting in an ultimate limb-salvage rate of 81%. CONCLUSIONS: The long-term results of this preoperative protocol for adults with limb-threatening STS appears to justify the utilization of a multimodality approach. This preoperative regimen was useful in minimizing limb loss in patients with limb-threatening STS. However, intraarterial doxorubicin administration is associated with significant morbidity, and its role in multimodality treatment of STS requires further clarification.
Authors: Jörg Thomas Hartmann; M Horger; T Kluba; A Königsrainer; P de Zwart; C Hann von Weyhern; F Eckert; W Budach; C Bokemeyer Journal: Invest New Drugs Date: 2013-10-04 Impact factor: 3.850
Authors: Dhara M MacDermed; Luke L Miller; Terrance D Peabody; Michael A Simon; Hue H Luu; Rex C Haydon; Anthony G Montag; Samir D Undevia; Philip P Connell Journal: Int J Radiat Oncol Biol Phys Date: 2009-07-04 Impact factor: 7.038
Authors: Kelly K Curtis; Jonathan B Ashman; Christopher P Beauchamp; Adam J Schwartz; Matthew D Callister; Amylou C Dueck; Leonard L Gunderson; Tom R Fitch Journal: Radiat Oncol Date: 2011-08-09 Impact factor: 3.481
Authors: Riikka Nevala; Erkki Tukiainen; Maija Tarkkanen; Tom Böhling; Carl Blomqvist; Mika Sampo Journal: Sci Rep Date: 2019-05-13 Impact factor: 4.379