Concomitant Radiation Therapy and Doxorubicin by Continuous Infusion in Advanced Malignancies - a Phase I-II Study - Evidence Of Synergistic Effect in Soft Tissue Sarcomas and Hepatomas

1986 ◽  
pp. 159-176 ◽  
Author(s):  
C. Julian Rosenthal ◽  
Marvin Rotman ◽  
Inder Bhutiani
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Synergistic Effect ◽  
Phase I ◽  
Continuous Infusion ◽  
Soft Tissue Sarcomas ◽  
Advanced Malignancies

Phase I study of neoadjuvant gemcitabine combined with radiation therapy for patients with high-risk extremity and trunk soft tissue sarcomas.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 10571-10571
Author(s):  
William W. Tseng ◽  
Shouhao Zhou ◽  
Peter F. Thall ◽  
Alexander J. F. Lazar ◽  
Raphael E. Pollock ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
High Risk ◽  
Soft Tissue ◽  
Phase I ◽  
Phase I Study ◽  
Soft Tissue Sarcomas

Phase I Trial of Preoperative Doxorubicin-Based Concurrent Chemoradiation and Surgical Resection for Localized Extremity and Body Wall Soft Tissue Sarcomas

2004 ◽  
Vol 22 (16) ◽  
pp. 3375-3380 ◽  
Author(s):  
Peter W.T. Pisters ◽  
Shreyaskumar R. Patel ◽  
Victor G. Prieto ◽  
Peter F. Thall ◽  
Valerae O. Lewis ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Phase I ◽  
Continuous Infusion ◽  
Surgical Resection ◽  
Phase I Trial ◽  
Body Wall ◽  
Soft Tissue Sarcomas ◽  
Maximum Tolerated Dose ◽  
External Beam Radiation ◽  
Preoperative Radiation

Purpose The primary objective of this phase I trial was to define the maximum-tolerated dose of continuous-infusion doxorubicin administered with standard preoperative radiation for patients with localized, potentially resectable soft tissue sarcomas of the extremities or body wall. Patients and Methods Twenty-seven patients with radiographically resectable intermediate- or high-grade soft tissue sarcomas were treated. Preoperative external-beam radiation was administered in 25 2-Gy fractions (total dose, 50 Gy). Concurrent continuous-infusion doxorubicin was administered by an initial bolus (4 mg/m2) and subsequent 4-day continuous infusion (12.5, 15.0, 17.5, or 20.0 mg/m2/wk). Radiographic restaging was performed 4 to 7 weeks after chemoradiation, and patients with localized disease underwent surgical resection. Results Chemoradiation was completed as an outpatient procedure in 25 patients (93%). The maximum-tolerated dose of continuous-infusion doxorubicin combined with standard preoperative radiation was 17.5 mg/m2/wk; at this dose level, seven (30%) of 23 patients had grade 3 dermatologic toxicity. Macroscopically complete resection (R0 or R1) was performed in all 26 patients who underwent surgery. Among 22 patients who were treated with doxorubicin 17.5/mg/m2/wk with concurrent radiation and subsequent surgery, 11 patients (50%) had 90% or greater tumor necrosis, including two patients who had complete pathologic responses. Conclusion Preoperative doxorubicin-based chemoradiation appears safe and feasible. The maximum-tolerated dose of continuous-infusion doxorubicin with standard preoperative radiation was 17.5 mg/m2/wk. Pathologic response rates with this regimen are encouraging.

Functional and psychosocial effects of multimodality limb-sparing therapy in patients with soft tissue sarcomas.

1989 ◽  
Vol 7 (9) ◽  
pp. 1217-1228 ◽  
Author(s):  
A E Chang ◽  
S M Steinberg ◽  
M Culnane ◽  
M H Lampert ◽  
A J Reggia ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Sexual Activity ◽  
Standardized Test ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
Postoperative Radiation ◽  
Limb Function ◽  
Postoperative Radiation Therapy ◽  
Global Quality Of Life

We have documented functional and psychosocial changes in patients with extremity soft tissue sarcomas who have undergone multimodality limb-sparing treatments. In 88 patients, parameters related to economic status, sexual activity, pain, limb function, and global quality of life (QOL) were recorded prior to surgery and every 6 months postoperatively. Changes from the preoperative assessment for every parameter were analyzed in each patient. Six months after surgery, there was a decrease in employment status, sexual activity, and in limb function in a significant number of patients. At 12 months, these decreases were still evident. Despite these changes, global QOL measured by a standardized test showed at least some improvement in a significant proportion of patients at 12 months. These findings highlight the difficulty in defining QOL. It could not be ascertained if radiation therapy and/or chemotherapy were causative factors in specific changes because of the small numbers of patients in each subgroup. However, among 60 patients with high-grade sarcomas, significant wound problems developed in 10 of 33 who received postoperative radiation therapy in combination with adjuvant doxorubicin and cyclophosphamide chemotherapy compared with one of 27 patients who received adjuvant chemotherapy alone (P = .016). Also, among high-grade sarcoma patients with 12-month follow-up, six of 19 patients who received radiation therapy and chemotherapy developed joint contractures compared with zero of 15 patients who received chemotherapy alone (P less than .04). The combination of postoperative radiation therapy and chemotherapy appeared to be associated with significantly more tissue-related injury in patients with high-grade sarcomas compared with chemotherapy alone.

OC-0087: Preoperative Hypofractionated Radiation Therapy for Soft Tissue Sarcomas of Extremity and Trunk

2020 ◽  
Vol 152 ◽  
pp. S40
Author(s):  
F. Navarria ◽  
A. Lauretta ◽  
E. Palazzari ◽  
R. Innocente ◽  
M. Gigante ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Hypofractionated Radiation Therapy ◽  
Hypofractionated Radiation

Flap Reconstruction of Sarcoma Defects in the Setting of Neoadjuvant and Adjuvant Radiation

2018 ◽  
Vol 35 (04) ◽  
pp. 287-293 ◽  
Author(s):  
Rohini Kadle ◽  
Catherine Motosko ◽  
George Zakhem ◽  
John Stranix ◽  
Timothy Rapp ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Radiation Treatment ◽  
Soft Tissue Sarcomas ◽  
Adjuvant Radiation ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Fasciocutaneous Flaps ◽  
Musculoskeletal Tumor Society

Background Limb-sparing treatment of extremity soft tissue sarcomas requires wide resections and radiation therapy. The resulting complex composite defects necessitate reconstructions using either muscle or fasciocutaneous flaps, often in irradiated wound beds. Methods A retrospective chart review was performed of all limb-sparing soft tissue sarcoma resections requiring immediate flap reconstruction from 2012 through 2016. Results Forty-four patients with 51 flaps were identified: 25 fasciocutaneous and 26 muscle-based flaps. Mean defect size, radiation treatment, and follow-up length were similar between groups. More often, muscle-based flaps were performed in younger patients and in the lower extremity. Seventeen flaps were exposed to neoadjuvant radiation, 12 to adjuvant radiation, 5 to both, and 17 to no radiation therapy. Regardless of radiation treatment, complication rates were comparable, with 28% in fasciocutaneous and 31% in muscle-based groups (p < 0.775). Muscle-based flaps performed within 6 weeks of undergoing radiotherapy were less likely to result in complications than those performed after greater than 6 weeks (p < 0.048). At time of follow-up, Musculoskeletal Tumor Society scores for fasciocutaneous and muscle-based reconstructions, with or without radiation, showed no significant differences between groups (mean [SD]: 91% [8%] vs. 89% [13%]). Conclusion The similar complication rates and functional outcomes in this study support the safety and efficacy of both fasciocutaneous flaps and muscle-based flaps in reconstructing limb-sparing sarcoma resection defects, with or without radiotherapy.

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