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Preoperative multimodality treatment for soft tissue sarcomas
E A Levine1, M Trippon, T K Das Gupta
1Division of Surgical Oncology, University of Illinois, Chicago 60612.
Cancer
|June 1, 1993
Summary
Preoperative intraarterial doxorubicin and radiation therapy improved limb salvage rates for soft tissue sarcomas (STS). This multimodality approach reduced amputations but had significant complications, warranting further study.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Physics
Background:
- Soft tissue sarcomas (STS) often present as large tumors, complicating local control.
- Effective preoperative strategies are needed to improve outcomes for limb-threatening STS.
Purpose of the Study:
- To evaluate a preoperative multimodality regimen for limb-threatening soft tissue sarcomas.
- To assess the efficacy and morbidity of intraarterial doxorubicin and radiation therapy.
Main Methods:
- A 10-day preoperative regimen of intraarterial doxorubicin (10 mg/m2/d) and radiation therapy (25 Gy) was administered to 55 adult patients with Stage T1 or T2 STS.
- Patients were treated between 1978-1991.
Main Results:
- The regimen achieved an initial limb-salvage rate of 87% in patients undergoing wide excision.
- Complications occurred in 26% of patients, with 7% requiring additional surgery.
- The 5-year overall survival was 69%, disease-free survival was 51%, and local control was achieved in 85% of patients.
- The ultimate limb-salvage rate was 81% after accounting for subsequent amputations.
Conclusions:
- Preoperative intraarterial doxorubicin combined with radiation therapy is a viable multimodality approach for limb-threatening STS, significantly minimizing limb loss.
- While effective, this regimen is associated with considerable morbidity, necessitating further investigation into its role and optimization in STS treatment.