Imaging response evaluation after neoadjuvant treatment in soft tissue sarcomas: Where do we stand?

2021 ◽  
Vol 160 ◽  
pp. 103309 ◽  
Author(s):  
Nicolò Gennaro ◽  
Sophie Reijers ◽  
Annemarie Bruining ◽  
Christina Messiou ◽  
Rick Haas ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Response Evaluation ◽  
Imaging Response

scholarly journals Focus on the Tumour Periphery in MRI Evaluation of Soft Tissue Sarcoma: Infiltrative Growth Signifies Poor Prognosis

Sarcoma ◽  
2006 ◽  
Vol 2006 ◽  
pp. 1-5 ◽  
Author(s):  
Josefin Fernebro ◽  
Marie Wiklund ◽  
Kjell Jonsson ◽  
Pär-Ola Bendahl ◽  
Anders Rydholm ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Growth Pattern ◽  
Tumour Growth ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Prognostic Information ◽  
Diffuse Infiltration ◽  
Increased Risk ◽  
Tumour Periphery ◽  
Mri Evaluation

Purpose. Infiltrative microscopical peripheral growth of soft tissue sarcomas (STS) has been shown to be of prognostic importance and preoperative risk stratification could individualize neoadjuvant treatment.Patients and methods. We assessed peripheral tumour growth pattern on preoperative MRI from 78 STS. The findings were correlated to histopathology and to outcome.Results. The MRI-based peripheral tumour growth pattern was classified as pushing in 34 tumours, focally infiltrative in 25, and diffusely infiltrative in 19. All tumours with diffuse infiltration on MRI also showed microscopical infiltration, whereas MRI failed to identify infiltration in two-thirds of the microscopically infiltrative tumours. Diffusely infiltrative growth on MRI gave a 2.5 times increased risk of metastases (P=.01) and a 3.7 times higher risk of local recurrence (P=.02).Discussion. Based on this observation we suggest that MRI evaluation of STS should focus on the peripheral tumour growth pattern since it adds prognostic information of value for decisions on neoadjuvant therapies.

scholarly journals Long-Term Clinical Responses of Neoadjuvant Dendritic Cell Infusions and Radiation in Soft Tissue Sarcoma

Sarcoma ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Shailaja Raj ◽  
Marilyn M. Bui ◽  
Gregory Springett ◽  
Anthony Conley ◽  
Sergio Lavilla-Alonso ◽  
...  
Keyword(s):  
Dendritic Cell ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
External Beam Radiation ◽  
Serious Adverse Events ◽  
Clinical Safety ◽  
Beam Radiation ◽  
Clinical Responses

Purpose. Patients with large >5 cm, high-grade resectable soft tissue sarcomas (STS) have the highest risk of distant metastases. Previously we have shown that dendritic cell (DC) based vaccines show consistent immune responses.Methods. This was a Phase I single institution study of neoadjuvant radiation with DC injections on 18 newly diagnosed high-risk STS patients. Neoadjuvant treatment consisted of 50 Gy of external beam radiation (EBRT), given in 25 fractions delivered five days/week, combined with four intratumoral injections of DCs followed by complete resection. The primary endpoint was to establish the immunological response to neoadjuvant therapy and obtain data on its clinical safety and outcomes.Results. There were no unexpected toxicities or serious adverse events. Twelve out of 18 (67%) patients were alive, of which an encouraging 11/18 (61%) were alive with no systemic recurrence over a period of 2–8 years. Favorable immunological responses correlated with clinical responses in some cases.Conclusions. This study provides clinical support to using dendritic cell injections along with radiation in sarcomas, which when used optimally in combination can help clinical outcomes in soft tissue sarcoma. Study registration number isNCT00365872.

scholarly journals Neoadjuvant Treatment Options in Soft Tissue Sarcomas

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2061
Author(s):  
Mateusz Jacek Spałek ◽  
Katarzyna Kozak ◽  
Anna Małgorzata Czarnecka ◽  
Ewa Bartnik ◽  
Aneta Borkowska ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Therapy ◽  
Treatment Options ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Therapy Response ◽  
Response Assessment ◽  
Treatment Type ◽  
Therapy Response Assessment

Due to the heterogeneity of soft tissue sarcomas (STS), the choice of the proper perioperative treatment regimen is challenging. Neoadjuvant therapy has attracted increasing attention due to several advantages, particularly in patients with locally advanced disease. The number of available neoadjuvant modalities is growing continuously. We may consider radiotherapy, chemotherapy, targeted therapy, radiosensitizers, hyperthermia, and their combinations. This review discusses possible neoadjuvant treatment options in STS with an emphasis on available evidence, indications for each treatment type, and related risks. Finally, we summarize current recommendations of the STS neoadjuvant therapy response assessment.

Nuclear SMAD4 as a predictor of survival in patientes with extremity soft tissue sarcomas submitted to neoadjuvant chemotherapy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10586-10586
Author(s):  
Isabela Werneck Cunha ◽  
Ranyell Spencer Sobreira Batista ◽  
Paulo Roberto Stevanato ◽  
Samuel Aguiar ◽  
Ademar Lopes ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Disease Free Survival ◽  
Chemotherapy Response ◽  
Surgical Specimen ◽  
Viable Cells ◽  
Low Expression

10586 Background: Neoadjuvant chemotherapy for locally advanced soft tissue sarcomas, although not standard, represents a promising option for resectable tumours. The discovery of biological predictors of chemotherapy response highlights the possibility to develop individualised therapeutic approaches in selected group of patients or predict survival also. The SMAD4 protein, a member of TGFβ superfamily has a role in progression and tumor metastasis and may be involved sarcomas recurrence. Methods: 30 patients with soft tissue sarcomas (STS) of high-grade located in extremities treated with neoadjuvant doxorubicin and ifosfamide chemotherapy were observed prospectively since January 2005 to June 2011. All patients were submitted to radiation therapy adjuvant. Surgical specimens after neoadjuvant treatment were evaluated of SMAD4 nuclear expression by immuno-histochemistry and percentage of viable cells Results: The median follow-up time was 42 months. The overall survival (OS) was 91.7% in patients with low expression SMAD4 nuclear protein associated with ≤10% of viable cells (n=12) in the surgical specimen and 68.9% in the remaining patients. Likewise, the disease free survival (DSF) was 91.7% versus 38.6% (p 0.01) respectively. Conclusions: The combination of nuclear SMAD4 low expression and 10% or less of viable cells in the surgical specimen was statistically significant in better DFS in patients with locally advanced extremity STS treated with neoajuvant chemotherapy with benefit in OS.

Neoadjuvant treatment improves capsular integrity and the width of the fibrous capsule of high-grade soft-tissue sarcomas

2013 ◽  
Vol 39 (1) ◽  
pp. 61-67 ◽  
Author(s):  
F. Grabellus ◽  
L.E. Podleska ◽  
S.-Y. Sheu ◽  
S. Bauer ◽  
C. Pöttgen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Fibrous Capsule ◽  
High Grade

Prospective cohort study of neoadjuvant treatment in conservative surgery of soft tissue sarcomas

1997 ◽  
Vol 23 (5) ◽  
pp. 468
Author(s):  
Walley J. Temple ◽  
Claire L.F. Temple ◽  
Keith Arthur ◽  
Norman S. Schachar ◽  
Alexander H.G. Paterson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Soft Tissue ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Conservative Surgery

scholarly journals Long-Term Follow-Up of Patients Receiving Neoadjuvant Treatment Modalties for Soft Tissue Sarcomas of the Extremities

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5244
Author(s):  
Miriam Rauch ◽  
Abbas Agaimy ◽  
Sabine Semrau ◽  
Alexander Willner ◽  
Oliver Ott ◽  
...  
Keyword(s):  
High Risk ◽  
Soft Tissue ◽  
Neoadjuvant Therapy ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Disease Free Survival ◽  
Treatment Modalities ◽  
Free Survival

Background: Neoadjuvant treatment modalities in soft tissue sarcoma (STS) of the extremities have become more popular in recent years, but because of the rarity and heterogeneity of STS, there are yet few studies on the long-term impact of neoadjuvant treatment modalities, especially in terms of neoadjuvant radiochemotherapy. Methods: The study enrolled 136 patients with primary STS of the extremities who underwent surgery with curative intent or neoadjuvant therapy, followed by surgery in a 15-year period. Neoadjuvant treatment consisted of radiotherapy (RT) with 60 Gy and in most cases simultaneous chemotherapy (CTx) with ifosfamide (1.5 g/m2/d, d1–5, q28) and doxorubicine (50 mg/m2/d, d3, q28). We investigated the clinical, (post)-operative and histopathological data and the oncological follow-up as well. The median follow-up period was 82 months (range 6–202). Results: A total of 136 patients (M:F = 73:63) with a mean age of 62 years (range; 21–93) was observed. Seventy-four patients (54.4%) received neoadjuvant therapy (NT), 62 patients (45.6%) received primary surgery (PS). When receiving NT, patients with high-risk STS had a lower risk to develop distant metastasis (p = 0.025). Age, histological type, tumor size and surgical margins (R0 vs. R1) had no influence on any survival rates. There was an association between NT and the occurrence of postoperative complications (p = 0.001). The 5-year local recurrence free survival (LRFS), metastasis free survival (MFS), disease free survival (DFS) and overall survival (OS) rate of the whole cohort was 89.9%, 77.0%, 70.6% and 72.6%; whereas the 5-year LRFS, MFS, DFS and OS rate was 90.5%, 67.2%, 64.1% and 62.8% for the NT group and 89.5%, 88.3%. 78.4% and 83.8% for the PS group. Conclusion: Multimodal treatment strategies in patients with STS of extremities lead to excellent oncological outcomes. Patients with high-risk STS had a significantly better MFS when receiving NT than patients with low-risk STS. NT was associated with a higher probability of postoperative but well-manageable complications.

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