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Intra-arterial induction chemotherapy for soft tissue sarcomas
A Azzarelli1, V Quagliuolo, S Fissi
1Division of Oncologia Chirurgica A, Insituto Nazionale Tumori, Milano.
Summary
Intra-arterial adriamycin chemotherapy for soft tissue sarcomas showed clinical responses in 38% of patients. While not improving survival, it aided limb-sparing surgery and identified patients with better prognoses.
Area of Science:
- Oncology
- Surgical Oncology
- Chemotherapy
Background:
- Soft tissue sarcomas are challenging malignancies.
- Recurrent and high-grade tumors present significant treatment difficulties.
- Preoperative chemotherapy aims to improve surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of intra-arterial adriamycin (i.a. ADR) as preoperative chemotherapy for large soft tissue sarcomas.
- To assess response rates, surgical outcomes, and survival.
- To determine the predictive value of treatment response on patient survival.
Main Methods:
- 101 patients with large soft tissue sarcomas received i.a. ADR preoperatively.
- Clinical and pathological responses were evaluated.
- Limb-sparing surgery was performed when feasible.
- Local recurrence rates and 5-year actuarial survival were analyzed.
Main Results:
- Among 78 high-grade evaluable patients, 38% showed clinical response and 45% showed pathological response.
- Limb-sparing surgery was achieved in 80% of cases.
- The 5-year actuarial survival rate was 50%, with a local recurrence rate of 29%.
- Clinical response was a significant predictor of survival (63% vs. 36% for responders vs. non-responders, p=0.01).
Conclusions:
- Intra-arterial adriamycin chemotherapy facilitated limb salvage surgery and identified patients with better prognoses.
- Clinical response to preoperative chemotherapy is a strong predictor of survival in soft tissue sarcoma.
- While direct survival benefits were not proven, the treatment aids in patient selection and surgical planning.