Neoadjuvant chemotherapy for radiation-associated soft-tissue sarcoma: A case report

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Radiation-associated sarcomas (RAS) are rare but aggressive malignancies.
• Optimal treatment for RAS, particularly chest wall tumors, remains challenging.
• The role of neoadjuvant chemotherapy in borderline resectable RAS is not well-defined.

Observation:

• A case of radiation-associated undifferentiated/unclassified soft-tissue sarcoma of the chest wall is presented.
• The patient had a centrally located, borderline resectable tumor.
• Neoadjuvant chemotherapy was administered due to the tumor's borderline resectability.

Findings:

• Doxorubicin plus ifosfamide chemotherapy demonstrated a favorable therapeutic effect.
• Pathological examination revealed greater than 90% tumor necrosis post-chemotherapy.
• This represents the first report of such high necrosis in this specific RAS subtype treated with neoadjuvant chemotherapy.

Implications:

• Neoadjuvant chemotherapy, specifically doxorubicin and ifosfamide, may be a viable strategy for downstaging borderline resectable RAS.
• Achieving significant tumor necrosis can potentially improve surgical resectability and patient outcomes.
• This case highlights a promising approach for managing rare and aggressive radiation-associated soft-tissue sarcomas.