Combination of Cisplatin, Ifosfamide, and Adriamycin as Neoadjuvant Chemotherapy for Extremity Soft Tissue Sarcoma: A Report of Twenty-Eight Patients.

Abstract

To investigate the clinical efficacy of neoadjuvant chemotherapy in the treatment of extremity soft tissue sarcomas (STSs). We retrospectively analyzed 28 patients with extremity STS that received 2 cycles of preoperative and 6 cycles of postoperative neoadjuvant chemotherapy between May 2009 and June 2012. Chemotherapy comprised intravenous cisplatin (DDP) (120  mg/m(2), for 1 day), followed 1 week later with 5 days 2  g/m(2) ifosfamide (IFO) and 3 days 30  mg/m(2) adriamycin (ADM). CT scans of the lungs and X-ray films of the lesion sites were reviewed. Eighteen patients were treated for primary tumor and 10 for tumor recurrence. Overall tumor diameter ranged from 8 to 30  cm based on body surface measurement. A total of 224 cycles of chemotherapy were carried out and patients were followed up for 12 to 59 months. Twenty-five patients underwent wide resection surgery (89.2%), and 3 underwent amputation (10.7%). Disease-free survival was realized in 20 patients and 3 patients survived with tumors. Two-year disease-free survival rate was 71.4%, and overall 2-year survival rate was 82.1%. Postoperative metastases were observed in 5 patients, and all died of lung metastases. Postoperative recurrence was observed in 4 patients (including 1 patient occurred metastases later). Tumor size was reduced by 30% ± 11.3% on average after the preoperative chemotherapy, and was reduced by 43% ± 7.8% in 22 patients with tumors >15  cm in the diameter. Twelve patients achieved partial remission, 14 stable disease and 2 experienced progressive disease. Objective response rate was 42.9%. Disease control rate was 92.9%. Chemotherapy was well tolerated in all the patients. Main adverse reactions were transient and resolved after chemotherapy. Neoadjuvant chemotherapy is effective in the treatment of extremity STS.

• Authors: Bing Wang, Xiuchun Yu, Songfeng Xu, Ming Xu
• Journal: Medicine (Medicine (Baltimore)) Vol. 95 Issue 4 Pg. e2611 (Jan 2016) ISSN: 1536-5964 [Electronic] United States
• PMID: 26825914 (Publication Type: Journal Article)

Chemical References

• Doxorubicin
• Cisplatin
• Ifosfamide

Topics

• Adolescent
• Adult
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Chemotherapy, Adjuvant (methods)
• Cisplatin (administration & dosage)
• Disease-Free Survival
• Doxorubicin (administration & dosage)
• Extremities
• Female
• Humans
• Ifosfamide (administration & dosage)
• Lung Neoplasms (diagnostic imaging, secondary)
• Male
• Middle Aged
• Neoadjuvant Therapy (methods)
• Neoplasm Recurrence, Local (drug therapy, pathology, surgery)
• Radiography
• Response Evaluation Criteria in Solid Tumors
• Retrospective Studies
• Sarcoma (drug therapy, secondary, surgery)
• Soft Tissue Neoplasms (drug therapy, pathology, surgery)
• Survival Rate
• Tumor Burden
• Young Adult