Prognostic variables in patients with primary soft tissue sarcoma of the extremity and trunk treated with neoadjuvant radiotherapy or neoadjuvant sequential chemoradiotherapy

Radiation Oncology

Dian Wang⁴  Robert Whitfield²  John Neilson³  Donald Hackbarth³  John Charlson⁶  Eduardo V Zambrano⁵  Tao Wang¹  Mikesh Shivakoti¹  David M King³  Meena Bedi⁴ 

[1] Department of Biostatistics Center, Medical College of Wisconsin, Milwaukee, WI, USA;Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA;Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA;Department of Radiation Oncology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53045, USA;Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA;Department of Medical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

关键词: Survival;    Prognostic factors;    Preoperative chemotherapy;    Preoperative radiation therapy;    Sarcoma;   

Others  :  1154393
DOI  :  10.1186/1748-717X-8-60

 received in 2012-10-03, accepted in 2013-03-05,  发布年份 2013

【 摘 要 】

Background

Neoadjuvant radiotherapy (NRT) is an effective strategy to treat soft tissue sarcomas (STS). However, the role of neoadjuvant chemoradiotherapy (NCRT) remains to be determined.

Methods

From May 1999 to July 2010, 112 patients with localized STS of the extremity and trunk who were treated with NRT or NCRT followed by surgery were retrospectively reviewed. Clinical outcomes including overall survival (OS), disease-free survival (DFS), and distant metastasis free survival (DMFS) were calculated using Kaplan-Meier survival analyses. Prognostic variables were determined by univariate (UVA) and multivariate analyses (MVA).

Results

Median follow-up was 37 months. Median RT dose was 50 Gy. Forty-nine patients received NCRT. Overall limb-preservation rate was 99% and local control was 97%. The estimated 3-year OS, DFS, and DMFS were 86%, 68%, and 72%, respectively. Age was the only variable to predict for OS, DFS and DMFS on UVA. Age ≥ 70 predicted for poor OS, stage III disease predicted for poor DFS and DMFS, and the addition of chemotherapy predicted for improved DMFS on MVA.

Conclusions

Excellent rates of local control and limb-preservation were observed in patients with primary STS treated with neoadjuvant therapy followed by surgery. Neoadjuvant sequential chemotherapy followed by radiotherapy may be considered for young patients with stage III STS.

【 授权许可】

   
2013 Bedi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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