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Titolo:
Survival after induction chemotherapy and surgical resection for high-grade soft tissue sarcoma. Is radiation necessary?
Autore:
Henshaw, RM; Priebat, DA; Perry, DJ; Shmookler, BM; Malawer, MM;
Indirizzi:
George Washington Univ, Washington Canc Inst, Div Orthoped Oncol, Washington, DC USA George Washington Univ Washington DC USA hoped Oncol, Washington, DC USA George Washington Univ, Washington Canc Inst, Dept Hematol Oncol, Washington, DC USA George Washington Univ Washington DC USA matol Oncol, Washington, DC USA Washington Hosp Ctr, Dept Pathol, Washington, DC 20010 USA Washington HospCtr Washington DC USA 20010 hol, Washington, DC 20010 USA
Titolo Testata:
ANNALS OF SURGICAL ONCOLOGY
fascicolo: 6, volume: 8, anno: 2001,
pagine: 484 - 495
SICI:
1068-9265(200107)8:6<484:SAICAS>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
ADJUVANT CHEMOTHERAPY; COMBINATION CHEMOTHERAPY; PROGNOSTIC FACTORS; LOCAL RECURRENCE; OSTEO-SARCOMA; DOXORUBICIN; IFOSFAMIDE; EXTREMITY; TRIAL; CISPLATIN;
Keywords:
induction chemotherapy; soft tissue sarcoma; survival rates; surgical resection; treatment;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
52
Recensione:
Indirizzi per estratti:
Indirizzo: Henshaw, RM Washington Hosp Ctr, Washington Canc Inst, 110 Irving St NW, Washington, DC 20010 USA Washington Hosp Ctr 110 Irving St NW Washington DC USA 20010 A
Citazione:
R.M. Henshaw et al., "Survival after induction chemotherapy and surgical resection for high-grade soft tissue sarcoma. Is radiation necessary?", ANN SURG O, 8(6), 2001, pp. 484-495

Abstract

Background: Induction chemotherapy can produce dramatic necrosis in sarcomas-raising the question of whether or not radiation is necessary. This study reviews the clinical outcome of a subset of patients with high-grade extremity soft tissue sarcomas (STS) who were treated with induction chemotherapy and surgical resection but without radiation. Methods: Nonmetastatic, large, high-grade STS of the pelvis and extremities were treated with intra-arterial cisplatin, adriamycin, and, after 1995, ifosfamide. After induction, oncologic resection and histologic evaluation were performed. Good responders with good surgical margins were not treatedwith radiation. Results: Thirty-three patients, with a median follow-up of 5 years, were included. Limb salvage rate was 94%. Median tumor necrosis was 95%. Four patients developed metastatic disease with three subsequent deaths. Two local recurrences occurred; both patients were salvaged with reresection and adjuvant external beam radiotherapy, although one died of metastatic disease 10years later. Relapse-free and overall survival is 80% and 88% at 5 and 10 years by Kaplan-Meier analysis. Conclusions: Intensive induction chemotherapy can be extremely effective for high-grade STS, permitting limb-sparing surgery in lieu of amputation. Radiation may not be necessary if a good response to induction chemotherapy and negative wide margins are achieved. All patients with large, deep, high-grade STS of the extremities should be considered candidates for inductionchemotherapy.

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Documento generato il 01/04/20 alle ore 11:19:27