Neoadjuvant chemoradiation compared to neoadjuvant radiation alone and surgery alone for Stage II and III soft tissue sarcoma of the extremities

Radiation Oncology

Tom R Fitch¹  Leonard L Gunderson⁴  Amylou C Dueck³  Matthew D Callister⁴  Adam J Schwartz²  Christopher P Beauchamp²  Jonathan B Ashman⁴  Kelly K Curtis¹ 

[1] Department of Internal Medicine, Division of Hematology/Oncology, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ 85259, USA;Department of Surgery, Division of Orthopedic Surgery, Mayo Clinic, 5779 East Mayo Blvd., Phoenix, AZ 85054, USA;Division of Biomedical Statistics and Informatics, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ 85259, USA;Department of Radiation Oncology, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ 85259, USA

关键词: extremity;    soft tissue sarcoma;    chemoradiation;    radiation;    chemotherapy;    Neoadjuvant;   

Others  :  1223924
DOI  :  10.1186/1748-717X-6-91

 received in 2011-03-22, accepted in 2011-08-09,  发布年份 2011

【 摘 要 】

Background

Neoadjuvant chemoradiation (NCR) prior to resection of extremity soft tissue sarcoma (STS) has been studied, but data are limited. We present outcomes with NCR using a variety of chemotherapy regimens compared to neoadjuvant radiation without chemotherapy (NR) and surgery alone (SA).

Methods

We conducted a retrospective chart review of 112 cases.

Results

Treatments included SA (36 patients), NCR (39 patients), and NR (37 patients). NCR did not improve the rate of margin-negative resections over SA or NR. Loco-regional relapse-free survival, distant metastases-free survival, and overall survival (OS) were not different among the treatment groups. Patients with relapsed disease (OR 11.6; p = 0.01), and tumor size greater than 5 cm (OR 9.4; p = 0.01) were more likely to have a loco-regional recurrence on logistic regression analysis. Significantly increased OS was found among NCR-treated patients with tumors greater than 5 cm compared to SA (3 year OS 69 vs. 40%; p = 0.03). Wound complication rates were higher after NCR compared to SA (50 vs. 11%; p = 0.003) but not compared to NR (p = 0.36). Wet desquamation was the most common adverse event of NCR.

Conclusions

NCR and NR are acceptable strategies for patients with STS. NCR is well-tolerated, but not clearly superior to NR.

【 授权许可】

   
2011 Curtis et al; licensee BioMed Central Ltd.

【 图 表 】

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