The role of Ifosfamide–doxorubicin chemotherapy in histology-specific, high grade, locally advanced soft tissue sarcoma, a 14-year experience
| Autor: | Aswini Padmanabhan, Barry W. Goy, Chris S. Helmstedter, Sajjad P Syed, Raoul J. Burchette |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Oncology medicine.medical_specialty medicine.medical_treatment Locally advanced Soft Tissue Neoplasms Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Doxorubicin Ifosfamide Retrospective Studies Chemotherapy business.industry Soft tissue sarcoma Sarcoma Histology Myxofibrosarcoma Hematology medicine.disease Trunk Treatment Outcome business medicine.drug |
| Zdroj: | Radiotherapy and Oncology. 165:174-178 |
| ISSN: | 0167-8140 |
| Popis: | To compare long-term outcomes of high-grade, primary soft-tissue-sarcoma (STS), using Ifosfamide-Doxorubicin vs local therapy alone, in histology-specific sarcomas.Retrospective analysis was performed on 127 patients from 2005 to 2018, with high-grade STS of extremity or trunk,5 cm, that were either Synovial-Cell, Dedifferentiated-Liposarcoma (DDL), Myxofibrosarcoma, Round-Cell-Liposarcoma (RCLS), Undifferentiated-Pleomorphic-Sarcoma (UPS), or Undifferentiated-Sarcoma-not-otherwise-specified (US-NOS), with central pathology review. Ifosfamide-Doxorubicin was generally given neoadjuvant over 5 cycles, followed by radiation and wide excision, with chemotherapy given in 38 patients, while 89 received local therapy alone. Multi-variable-analysis (MVA) of prognostic factors was performed, and local-recurrence-free-survival (LRFS), distant-metastases-free-survival (DMFS), disease-specific-survival (DSS), and overall-survival (OS) were estimated using Kaplan-Meier, and adjusted using propensity-score matching.Median follow-up was 4.5 years. Younger age (p 0.0001) and Synovial histology (p = 0.0002) were more likely to undergo chemotherapy. Ifosfamide-Doxorubicin improved 5-year DMFS (p = 0.02), DSS (p = 0.01), and OS (p = 0.01), by univariate comparisons, as well as sub-analysis of non-synovial histology, but significance was lost after propensity-score matching for DMFS (p = 0.10), DSS (p = 0.09), and OS (p = 0.07). Size10 cm, trunk location, and lack of chemotherapy significantly lowered DMFS, DSS, and OS on MVA, while DDL had more favorable survival; although size, trunk location, and DDL histology were not significantly different between treatment groups. Ifosfamide-Doxorubicin independently improved DMFS (p = 0.001), DSS (p = 0.01), and OS (p = 0.001) on MVA.Ifosfamide-Doxorubicin may be more beneficial in younger patients with5 cm, high-grade, STS of the trunk or extremity in Synovial-Cell, DDL, Myxofibrosarcoma, RCLS, UPS, and US-NOS. |
| Databáze: | OpenAIRE |
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