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- Title
Adjuvant chemotherapy—Radiotherapy—Chemotherapy sandwich protocol in resectable soft tissue sarcoma: An updated single-center analysis of 104 cases.
- Authors
Schliemann, Christoph; Kerkhoff, Andrea; Hesse, Paula; Bröckling, Sebastian; Hardes, Jendrik; Streitbürger, Arne; Andreou, Dimosthenis; Gosheger, Georg; Elges, Sandra; Wardelmann, Eva; Hartmann, Wolfgang; Mesters, Rolf; Lenz, Georg; Willich, Normann; Kriz, Jan; Eich, Hans; Berdel, Wolfgang E.; Kessler, Torsten
- Abstract
Adjuvant therapy of local soft tissue sarcomas (STS) after wide surgical excision still is a topic under controversial scientific debate. In this single center report we have offered an adjuvant “sandwich” therapy protocol consisting of 4 cycles of doxorubicin (75 mg/m2 i.v. over 1 h on day 1) followed by ifosfamide (5 g/m2 i.v. over 24 h starting on day 1) and local radiotherapy scheduled between chemotherapy cycles 2 and 3 to 104 consecutive patients after wide surgical excision (R0) of histologically proven high-grade STS. After a mean follow-up of 39 months (range 5–194 months) relapse free survival (RFS) at 2 and 5 years was 68.1% (95% CI, 58.5–77.7%) and 61.2% (95% CI, 50.4–71.6%). When analyzing the 82 STS cases of the extremities only 2- and 5-year RFS was 74.0% (95% CI, 64.0–84.0%) and 65.3% (95% CI, 53.7–76.9%). By intent-to-treat analysis, the overall survival (OS) at 2 years was 87.3% (95% CI, 80.5–94.1%) and 75.6% (95% CI, 65.2–86.0%) at 5 years, while OS for STS of the extremities only cohort was 90.5% (95% CI, 83.7–97.3%) and 79.0% (95% CI, 68.4–89.6%), respectively. Tolerability of the treatment was good. This analysis demonstrates the feasibility of adjuvant chemoradiotherapy and reflects the results of the long lasting intensive multidisciplinary team approach at our “high-volume” sarcoma center. The long-term survival in our patients is among the highest reported and the low local and distant recurrence rate in high-risk STS is at least comparable to the published data.
- Subjects
ADJUVANT treatment of cancer; CANCER chemotherapy; SOFT tissue tumors; SURGICAL excision; RADIOTHERAPY; CHEMORADIOTHERAPY; TUMOR treatment
- Publication
PLoS ONE, 2018, Vol 13, Issue 5, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0197315