Intensified Adjuvant IFADIC Chemotherapy for Adult Soft Tissue Sarcoma: A Prospective Randomized Feasibility Trial

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Soft tissue sarcoma (STS) management often involves multimodal therapy.
• Adjuvant chemotherapy and radiotherapy are used to improve outcomes after surgical resection.

Purpose of the Study:

• To compare the toxicity, feasibility, and efficacy of adjuvant chemotherapy combined with hyperfractionated accelerated radiotherapy (HART) versus HART alone.
• To evaluate outcomes in patients with grade 2 and grade 3 soft tissue sarcoma following wide or marginal resection.

Main Methods:

• A prospective randomized trial involving 59 patients with STS.
• Patients received either HART alone or HART plus six courses of ifosfamide, dacarbazine (DTIC), and doxorubicin (IFADIC) chemotherapy.
• Chemotherapy was supported by granulocyte-colony stimulating factor.

Main Results:

• The relative IFADIC dose intensity was 93%.
• No significant differences were observed in relapse-free survival (RFS), time to local failure (TLF), time to distant failure (TDF), or overall survival (OS) between the groups.
• Tumor relapse rates were numerically lower in the chemotherapy group (23%) compared to the control group (43%).
• Treatment-related toxicity was generally mild in both arms.

Conclusions:

• Intensified IFADIC chemotherapy added to HART is manageable and tolerable for STS patients.
• The addition of intensified IFADIC chemotherapy did not lead to statistically significant improvements in survival outcomes compared to radiotherapy alone.
• Further validation in larger prospective trials is needed to explore potential benefits in grade 3 STS patients.