Epirubicin and Ifosfamide with Preoperative Radiation for High-Risk Soft Tissue Sarcomas.
BACKGROUND: The optimal treatment of high-risk soft tissue sarcomas (STS) of the extremities remains controversial. We report follow-up from a phase II study of dose-intense chemotherapy with preoperative hypofractionated radiation in this population supplemented with subsequent data from an extensive institutional experience using this regimen.
METHODS: Patients with localized, intermediate- or high-grade STS of the extremity or body wall measuring > 5 cm were treated with epirubicin 30 mg/m
RESULTS: The 5-year rates for overall survival, distant disease-free survival, and freedom from local regional failure were 70.4% (95% CI 59.2-83.7%), 55.9% (95% CI 44.5-70.2%), and 87.2% (95% CI 77.9-96.5%) respectively. Thirty-eight percent of tumors (29/76) demonstrated ≥ 90% pathologic response. Wound complications occurred in 32% (24/76) of patients.
DISCUSSION: Treatment with preoperative radiation and pre- and post-operative epirubicin and ifosfamide was associated with favorable clinical outcomes. Survival and recurrence rates were comparable to those reported with other preoperative chemotherapy regimens in high-risk extremity sarcomas. Use of trimodality therapy should be considered for appropriate high-risk STS patients.
Annals of surgical oncology : the official journal of the Society of Surgical Oncology
Lu, Eric; Perlewitz, Kelly S; Hayden, James B; Hung, Arthur Y; Doung, Yee-Cheen; Davis, Lara E; Mansoor, Atiya; Vetto, John T; Billingsley, Kevin G; Kaempf, Andy; Park, Byung; and Ryan, Christopher W, "Epirubicin and Ifosfamide with Preoperative Radiation for High-Risk Soft Tissue Sarcomas." (2018). All Publications. 128.