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Preoperative regional therapy for extremity sarcoma. A tricenter update
H J Wanebo1, W J Temple, M B Popp
1Department of Surgery, Brown University, Providence, RI 02908, USA.
Cancer
|May 1, 1995
Summary
Preoperative radiation with sensitizing doxorubicin offers excellent local control for extremity sarcomas, achieving a 98.5% rate. While long-term tumor control is reasonable, distant metastases remain a significant challenge in treatment.
Area of Science:
- Oncology
- Surgical Oncology
- Radiation Oncology
Background:
- High-grade extremity sarcomas are often treated with preoperative radiation and chemotherapy.
- A multi-institutional study updated findings from a protocol initiated in 1984.
Purpose of the Study:
- To evaluate the efficacy of preoperative radiation with sensitizing doxorubicin followed by resection for extremity sarcomas.
- To assess local control, survival rates, and prognostic factors in a multicenter setting.
Main Methods:
- Patients received intra-arterial doxorubicin and varying doses of preoperative radiation (30-35 Gy or 46 Gy).
- Surgical resection was performed within 10-30 days, with some patients receiving postoperative chemotherapy.
- Limb salvage surgery was prioritized, with amputation reserved for specific cases.
Main Results:
- 66 patients with various sarcoma types (soft-tissue and bone) were analyzed.
- 5-year overall and disease-free survival rates were 59% and 49%, respectively.
- Excellent local control (98.5%) was achieved, but distant metastases were a challenge.
Conclusions:
- Combined preoperative radiation and chemotherapy demonstrate high local control for extremity sarcomas.
- Distant metastases remain a significant challenge, impacting long-term outcomes.
- Surgical resection extent is a key factor for overall survival.