scholarly journals Adjuvant chemotherapy in soft tissue sarcomas…Conflicts, consensus, and controversies

2016 ◽  
Vol 05 (01) ◽  
pp. 15-19 ◽  
Author(s):  
Jyoti Bajpai ◽  
Deepa Susan
Keyword(s):  
Adjuvant Chemotherapy ◽  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Patient Outcomes ◽  
Treatment Options ◽  
Specific Treatment ◽  
Soft Tissue Sarcomas ◽  
Metastatic Potential ◽  
Diverse Group ◽  
Histologic Subtypes

AbstractSoft tissue sarcomas (STSs) are an uncommon and diverse group of more than 50 mesenchymal malignancies. Each of these histologic subtypes represents a unique disease with distinct biologic behavior and varying sensitivity to chemotherapy. The judicious use of adjuvant/neoadjuvant chemotherapy along with surgery and radiation in the treatment of localized STS has a role in improving patient outcomes by decreasing local and distant recurrences. There is evidence that the use of adjuvant chemotherapy to a mixed cohort of chemo sensitive and insensitive sarcoma subtypes results in limited benefit. Therefore, it is of paramount importance to identify the subpopulation with high metastatic potential and to identify effective histology-specific treatment options to these patients. Present perspective, will focus on the rationale for adjuvant chemotherapy in sarcoma, with emphasis on the histology driven chemotherapy. It will outline key therapeutic opportunities and hurdles in adjuvant medical treatment of sarcoma, focusing on specific subtypes that are on the verge of new breakthroughs, as well as those in which promise has not lived up to expectations.

Adjuvant and Neoadjuvant Chemotherapy for Soft Tissue Sarcomas: A Personal Point of View

2017 ◽  
Vol 103 (3) ◽  
pp. 213-216 ◽  
Author(s):  
Robert S. Benjamin
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Chemotherapeutic Agent ◽  
Soft Tissue Sarcomas ◽  
Point Of View ◽  
Medical Oncologists

Dr. Gianni Bonadonna is internationally recognized as one of the foremost medical oncologists of the 20th century. He is best known for his pioneering work in the development of adjuvant chemotherapy for breast cancer, but he was also the father of sarcoma chemotherapy. The first investigator to study the new chemotherapeutic agent adriamycin in the late 1960s, he noted activity against sarcomas. This article, focusing on adjuvant chemotherapy, adriamycin, and sarcomas, memorializes his achievements and their progeny.

Indication for neoadjuvant chemotherapy in adult patients with high-risk soft-tissue sarcomas

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9578-9578
Author(s):  
B. Kasper ◽  
E. Kuehl ◽  
P. Wuchter ◽  
L. Bernd ◽  
A. D. Ho ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Disease Progression ◽  
Response Rate ◽  
Objective Response ◽  
Soft Tissue Sarcomas ◽  
First Diagnosis

9578 Background: To determine the efficacy and safety of neoadjuvant chemotherapy for local tumour control and overall survival in patients with high-risk soft-tissue sarcomas (tumour size ≥ 5 cm, G II/III, extracompartimental and deep localisation) we have analyzed the clinical outcome in 25 patients. Methods: Patients with high-risk soft-tissue sarcomas were treated with four cycles of etoposide 125 mg/m2/day 1+4, ifosfamide 1500 mg/m2/day 1–4 and doxorubicin 50 mg/m2/day 1 (EIA regimen) followed by definitive surgery with or without postoperative radiotherapy and adjuvant chemotherapy. 21 patients received chemotherapy in a combined neoadjuvant/adjuvant clinical setting; eighteen of them completed adjuvant chemotherapy. Four patients received chemotherapy in an adjuvant setting only. Results: The objective response rate of neoadjuvant chemotherapy assessable in 21 patients was 43%. Including NED (n = 7) and partial remissions (n = 3), the radiographic response rate was 47.6% with additional 42.9% stable diseases (n = 9). Surgery was performed in two patients before completing the four neoadjuvant chemotherapy cycles because of disease progression. Median overall survival for all patients from the time of first diagnosis was 21.6+ months [range: 8 - 50] and from the start of treatment 20.5+ months [range: 8 - 49]; median progression-free survival after start of treatment was 18.6+ months [range: 1 - 49]. After completion of chemotherapy, R0-resection could be performed in 13 of 21 patients (60%). At completion of entire treatment, 21 of 25 patients (84%) had NED after R0- and R1-resection. Two patients showed no disease progression after R2-resection and are alive with disease (AWD) 21 and 18 months after start of treatment. Two patients died of disease (DOD) ten and eight months after first diagnosis due to metastases. Conclusions: The high proportion of R0-resections supports the idea of a tumour downstaging after neoadjuvant treatment. Our data support the hypothesis that neoadjuvant chemotherapy might be beneficial as an integral part in the treatment strategy of high-risk soft-tissue sarcoma patients. No significant financial relationships to disclose.

53 Neoadjuvant chemotherapy and radiotherapy for large soft tissue sarcomas

1996 ◽  
Vol 36 (1) ◽  
pp. 185 ◽  
Author(s):  
Ira J. Spiro ◽  
Damian Dupuis ◽  
Herman Suit ◽  
Henry Mankin ◽  
Candace Jennings ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Soft Tissue Sarcomas

MR-imaging changes of musculoskeletal soft-tissue sarcomas associated with neoadjuvant chemotherapy and hyperthermia

2003 ◽  
Vol 19 (4) ◽  
pp. 391-401 ◽  
Author(s):  
A. Baur ◽  
A. Stäbler ◽  
C. M. Wendtner ◽  
S. Arbogast ◽  
S. A. Rahman ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Mr Imaging ◽  
Soft Tissue Sarcomas

scholarly journals T2 -based MRI Delta-radiomics improve response prediction in soft-tissue sarcomas treated by neoadjuvant chemotherapy.

2018 ◽  
Vol 50 (2) ◽  
pp. 497-510 ◽  
Author(s):  
Amandine Crombé ◽  
Cynthia Périer ◽  
Michèle Kind ◽  
Baudouin Denis De Senneville ◽  
François Le Loarer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Soft Tissue Sarcomas ◽  
Response Prediction

A randomized trial for the treatment of high-grade soft-tissue sarcomas of the extremities: preliminary observations.

1986 ◽  
Vol 4 (4) ◽  
pp. 552-558 ◽  
Author(s):  
F Gherlinzoni ◽  
G Bacci ◽  
P Picci ◽  
R Capanna ◽  
P Calderoni ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Soft Tissue ◽  
Local Treatment ◽  
Soft Tissue Sarcomas ◽  
Rank Test ◽  
High Grade ◽  
Chemotherapy Group ◽  
The Difference ◽  
To Receive ◽  
Observation Period

A new trial for evaluating the effectiveness of adjuvant chemotherapy in high-grade soft-tissue sarcomas of the extremities in adult patients is presented. All patients after local treatment were randomized into two arms, one without further therapy and the other to receive adjuvant chemotherapy (Adriamycin [Farmitalia-Carlo Erba, Milan, Italy], 450 mg/m2). The preliminary results of the study are reported at a median observation period of 27.6 months. Of the 59 patients who entered the study, 79.1% in the chemotherapy group are without sign of disease, whereas the corresponding figure in the nonadjuvant chemotherapy group is 54.3%. The difference between the two groups is statistically significant (P less than .005, log rank test). These preliminary observations encourage continuation of the study.

Sign in / Sign up

Export Citation Format

Share Document