Intra-arterial adriamycin followed by surgery for limb sarcomas. Preliminary report

A multimodal treatment schedule for operable soft tissue sarcomas is ongoing in our institution. The main purposes are to achieve an easier radical surgery with limb preservation and to lower the risk of local relapses. Patients with documented untreated soft tissue sarcoma of the lower limb are given continuous intra-arterial regional infusion with adriamycin consecutively for 8 days up to a dose of 100 mg/m2. Radical surgery is performed by the fourth day after infusion. Preliminary data on 13 cases are available: after infusion only 6 patients presented reduction of the tumor diameters, but almost all postoperative histological examinations revealed wide areas of necrosis (up to 100%) of tumor tissue (in 9 cases greater than 50%). In 4 patients surgical treatment was completed with radiotherapy. In 2 cases the preliminary indication to disarticulation could be modified in wide excision after the postinfusional tumor reduction. The toxicity of adriamycin was typical and acceptable. Further data will be available after adequate follow-up and when more patients enter the study. These data document the feasibility of this multimodal treatment and its validity in terms of specific tumor tissue toxicity and improved surgical approach.