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Response to neoadjuvant thermochemotherapy as significant prognosticator for long-term survival of patients with retroperitoneal or visceral high-risk soft-tissue sarcoma
Li Liu, MD
University of Pennsylvania Cancer
Ultima Vez Modificado: 15 de mayo del 2001
The clinical application of hyperthermia with increase of tissue temperatures (range 40-44 degrees C) has been integrated in multimodal anti- cancer strategies. The combination of hyperthermia and chemotherapy or radiochemotherapy has been tested within clinical protocols in order to improve local tumor control and relapse-free survival in patients with high- risk sarcomas.
Materials and Methods:
- A total of 58 patients with high-risk retroperitoneal or visceral (RP/V) sarcoma were included in this prospective study.
- Patients were treated with 4 cycles of VP-16, ifosfamide and adriamycin combined with regional hyperthermia (RHT) followed by surgery, more chemotherapy and radiation therapy.
- Tumor size was > 5cm.
- Overall response rate was 33%
- Pathologic response rate in 26 patients after surgical resection was 42%
- 25 patients achieved initial complete response
- Median survival was 31 months and 5-year overall survival was 32%
- Response to neoadjuvant thermochemotherapy was a prognostic factor of overall survival
- Patients who responded to neoadjuvant thermochemotherapy appeared to have improved survival.
- The importance of RHT for local tumor control will be tested in a phase III trial.
- The retroperitoneal/visceral soft tissue sarcomas carry a formidable prognosis. Although widely used, the roles of adjuvant radiation therapy and chemotherapy have not been established.
- New therapeutic agents as well as innovative combined-modality approaches are needed to achieve better outcome.
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