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.

scholarly journals 18F-FDG PET/MRI for Therapy Response Assessment of Isolated Limb Perfusion in Patients with Soft-Tissue Sarcomas

2019 ◽  
Vol 60 (11) ◽  
pp. 1537-1542 ◽  
Author(s):  
Johannes Grueneisen ◽  
Benedikt Schaarschmidt ◽  
Aydin Demircioglu ◽  
Michal Chodyla ◽  
Ole Martin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Fdg Pet ◽  
Soft Tissue Sarcomas ◽  
Therapy Response ◽  
Response Assessment ◽  
Isolated Limb Perfusion ◽  
Limb Perfusion ◽  
Therapy Response Assessment ◽  
18F Fdg

scholarly journals MRI for Assessing Response to Neoadjuvant Therapy in Locally Advanced Rectal Cancer Using DCE-MR and DW-MR Data Sets: A Preliminary Report

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Mario Petrillo ◽  
Roberta Fusco ◽  
Orlando Catalano ◽  
Mario Sansone ◽  
Antonio Avallone ◽  
...  
Keyword(s):  
Neoadjuvant Therapy ◽  
Interobserver Agreement ◽  
Locally Advanced ◽  
Therapy Response ◽  
Response Assessment ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Dce Mri ◽  
Before And After ◽  
Therapy Response Assessment

To evaluate MRI for neoadjuvant therapy response assessment in locally advanced rectal cancer (LARC) using dynamic contrast enhanced-MRI (DCE-MRI) and diffusion weighted imaging (DWI), we have compared magnetic resonance volumetry based on DCE-MRI (V(DCE)) and on DWI (V(DWI)) scans with conventional T2-weighted volumetry (V(C)) in LARC patients after neoadjuvant therapy. Twenty-nine patients with LARC underwent MR examination before and after neoadjuvant therapy. A manual segmentation was performed on DCE-MR postcontrast images, on DWI (b-value 800 s/mm2), and on conventional T2-weighted images by two radiologists. DCE-MRI, DWI, and T2-weigthed volumetric changes before and after treatment were evaluated. Nonparametric sample tests, interobserver agreement, and receiver operating characteristic curve (ROC) were performed. Diagnostic performance linked to DCE-MRI volumetric change was superior to T2-w and DW-MRI volumetric changes performance (specificity 86%, sensitivity 93%, and accuracy 93%). Area Under ROC (AUC) ofV(DCE) was greater than AUCs ofV(C) andV(DWI) resulting in an increase of 15.6% and 11.1%, respectively. Interobserver agreement between two radiologists was 0.977, 0.864, and 0.756 forV(C),V(DCE), andV(DWI), respectively.V(DCE) seems to be a promising tool for therapy response assessment in LARC. Further studies on large series of patients are needed to refine technique and evaluate its potential value.

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.

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.

scholarly journals Clinical Factors That Affect the Establishment of Soft Tissue Sarcoma Patient-Derived Orthotopic Xenografts: A University of California, Los Angeles, Sarcoma Program Prospective Clinical Trial

2017 ◽  
pp. 1-13 ◽  
Author(s):  
Tara A. Russell ◽  
Mark A. Eckardt ◽  
Takashi Murakami ◽  
Irmina A. Elliott ◽  
Kei Kawaguchi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Los Angeles ◽  
Neoadjuvant Therapy ◽  
Neoadjuvant Treatment ◽  
Soft Tissue Sarcomas ◽  
Pathologic Response ◽  
Response To Treatment ◽  
High Grade ◽  
Factors Associated ◽  
Orthotopic Xenografts

Purpose Given the diverse and aggressive nature of soft tissue sarcomas (STSs), a need exists for more-precise therapy. Patient-derived orthotopic xenografts (PDOXs) provide a unique platform for personalized treatment. Thus, identification of patient and treatment factors that predict PDOX establishment is important. This study assessed the feasibility of incorporating PDOXs into the clinical setting and identifying factors associated with PDOX establishment. Patients and Methods From May 2015 to May 2016, 107 patients with biopsy-proven or potential STS were enrolled. Tumor samples were obtained intraoperatively and orthotopically implanted into nude mice in the corresponding anatomic location. PDOXs were considered established after engraftment and serial passage. Factors associated with establishment were analyzed by logistic regression and time to establishment by time-to-event analysis. Results Only high-grade tumors established (32 of 72 [44.4%]). The establishment rate (ER) varied by neoadjuvant therapy and treatment response, with the highest ER among untreated high-grade tumors (26 of 42 [61.9%]). Tumors exposed to radiation preoperatively did not establish (zero of 11 [0%]), and tumors exposed to neoadjuvant chemotherapy had a lower ER (31.9%) than untreated tumors. Only STSs with minimal pathologic response to neoadjuvant treatment (≤ 30%) established a PDOX (six of 18 [33.3%]). Median establishment time was 54 days, which varied by neoadjuvant therapy but was not statistically significant ( P = .180). Conclusion To our knowledge, in the largest STS PDOX study to date, we demonstrate a 62% ER among untreated high-grade tumors with a median establishment time of 54 days. Neoadjuvant therapy, particularly radiation, and pathologic response to treatment were associated with a reduced rate of PDOX establishment.

Sign in / Sign up

Export Citation Format

Share Document