Neoadjuvant chemoradiation therapy for soft tissue sarcomas of the extremities

Authors

  • Samuel Aguiar Junior Fundação Antônio Prudente; Hospital do Câncer A.C. Camargo; Departamento de Cirurgia Pélvica
  • Fábio de Oliveira Ferreira Fundação Antônio Prudente; Hospital do Câncer A.C. Camargo; Departamento de Cirurgia Pélvica
  • Benedito Mauro Rossi Fundação Antônio Prudente; Hospital do Câncer A.C. Camargo; Departamento de Cirurgia Pélvica
  • Érika Maria Monteiro Santos Fundação Antônio Prudente; Hospital do Câncer A.C. Camargo; Departamento de Cirurgia Pélvica
  • João Victor Salvajoli Fundação Antônio Prudente; Hospital do Câncer A.C. Camargo; Departamento de Radioterapia
  • Ademar Lopes Fundação Antônio Prudente; Hospital do Câncer A.C. Camargo; Departamento de Cirurgia Pélvica

DOI:

https://doi.org/10.1590/S1807-59322009001100005

Keywords:

Connective tissue neoplasms, Radiotherapy, Chemotherapy, Adjuvant treatment, Survival

Abstract

INTRODUCTION AND OBJECTIVE: Neoadjuvant and adjuvant therapies for soft tissue sarcomas of the extremities are still controversial. The aim of this study was to analyze the results of a protocol of neoadjuvant chemoradiation therapy for extremity sarcomas. METHODS: A retrospective analysis was carried out in a consecutive series of 49 adult patients with advanced extremity soft tissue sarcomas that could not be resected with adequate margins during the primary resection. All patients were treated with a protocol of preoperative radiation therapy at a total dose of 30 Gy, concomitant with doxorubicin (60 mg/m²) chemotherapy. The main endpoints assessed were local recurrence-free survival, metastasis-free survival and overall survival. The median follow-up time was 32.1 months. RESULTS: The five-year local recurrence-free survival, metastasis-free survival and overall survival rates were 81.5%, 46.7% and 58.3%, respectively. For high-grade tumors, the five-year metastasis-free and overall survival rates were only 36.3% and 41.2%, respectively. Severe wound complications were observed in 41.8% of the patients who underwent surgery. These complications precluded adjuvant chemotherapy in 73.7% (14/19) of the patients eligible to receive it. CONCLUSIONS: In this study, neoadjuvant chemoradiation therapy was associated with a good local control rate, but the distant relapse-free rate and overall survival rate were still poor. The high rate of wound complications modified the planning of adjuvant treatment in most patients.

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Published

2009-11-01

Issue

Section

Clinical Sciences

How to Cite

Aguiar Junior, S., Ferreira, F. de O., Rossi, B. M., Santos, Érika M. M., Salvajoli, J. V., & Lopes, A. (2009). Neoadjuvant chemoradiation therapy for soft tissue sarcomas of the extremities . Clinics, 64(11), 1059-1064. https://doi.org/10.1590/S1807-59322009001100005