Limb salvage in extremity soft-tissue sarcoma: combined modality therapy.

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• High-grade soft-tissue sarcomas of the extremity present significant treatment challenges.
• Multimodal therapy is often required for optimal patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of preoperative intra-arterial Adriamycin (doxorubicin) combined with radiotherapy for high-grade extremity soft-tissue sarcomas.
• To assess treatment-related morbidity, local recurrence rates, and survival outcomes.

Main Methods:

• Thirty-two patients with high-grade extremity soft-tissue sarcoma received neoadjuvant therapy.
• Treatment involved intra-arterial Adriamycin (doxorubicin) infusion and concurrent radiotherapy (25 Gy in 2 weeks) followed by en bloc resection.
• Postoperative radiotherapy was administered based on surgical findings.

Main Results:

• 28% of surgical specimens showed no residual tumor, and 41% had minimal tumor.
• A functionally intact limb was preserved in 94% of patients.
• Local recurrence occurred in only 3% of patients, with 3-year overall survival at 70% and disease-free survival at 57%.

Conclusions:

• Preoperative combined Adriamycin (doxorubicin) and radiotherapy is an effective neoadjuvant strategy for high-grade extremity soft-tissue sarcomas.
• This approach achieves high rates of tumor downstaging and limb salvage with low local recurrence.
• The regimen demonstrates favorable long-term survival outcomes, supporting its use in clinical practice.