In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 20, No. 14 ( 2002-07-15), p. 3156-3164
Abstract:
PURPOSE: To determine the efficacy of neoadjuvant chemotherapy combined with regional hyperthermia (RHT) for local tumor control and overall survival (OS) in adult patients with retroperitoneal or visceral (RP/V) high-risk soft tissue sarcomas (HR-STS). PATIENTS AND METHODS: From 1991 to 1997, 58 patients with HR-STS at RP/V sites were prospectively treated with four cycles of etoposide, ifosfamide, and doxorubicin combined with RHT followed by surgery, adjuvant chemotherapy, and radiation. RESULTS: Objective response rate assessable in 40 patients was 13% (five partial responses). Including minor responses (n = 8), the radiographic response rate was 33%. The pathologic response rate assessable in 26 patients after surgical resection was 42%. Median OS was 31 months. At a median observation time of 74 months, 5-year probability of local failure-free survival (LFFS), distant metastasis-free survival, event-free survival, and OS were 25%, 51%, 20%, and 32%, respectively. Averaged minimum temperatures (T min ) and time-averaged temperatures achieved in 50% (T 50 ) and 90% (T 90 ) of all measured tumor sites differed significantly between responders and nonresponders (T min , 39.3°C v 38.0°C; P = .002; T 50 , 40.9°C v 40.3°C; P = .038; T 90 , 40.1°C v 39.3°C; P = .017). At 5-year follow-up, probability of LFFS (59% v 0%; P 〈 .001) and OS (60% v 10%; P 〈 .001) was significantly in favor of patients responding to neoadjuvant thermochemotherapy. CONCLUSION: Response to neoadjuvant chemotherapy combined with RHT is predictive for an improved local tumor control resulting in a long-term survival benefit for patients with HR-STS at unfavorable RP/V sites; however, the impact of RHT has to be defined in a randomized phase III trial.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2002.07.146
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2002
detail.hit.zdb_id:
2005181-5
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