Long-term results of preoperative intra-arterial doxorubicin combined with neoadjuvant radiotherapy, followed by extensive surgical resection for locally advanced soft tissue sarcomas of the extremities

PHA Nijhuis, E Pras, DT Sleijfer, WM Molenaar, HJ Hoekstra*, H. Schraffordt Koops

*Corresponding author for this work

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    Abstract

    Background and purpose: In the 1980s a combined modality therapy of intraarterial doxorubicin, neoadjuvant radiotherapy and surgery was initiated at the Groningen University Hospital as a limb-saving treatment for locally advanced, primarily irresectable high-grade soft tissue sarcomas (STS) of the extremities. This study presents the short- and long-term results.

    Patients and methods: Between 1983 and 1987, 11 patients were treated with intraarterial doxorubicin, preoperative radiotherapy (10 x 3.5 Gy) and surgical resection. Non-radical resections received additional postoperative radiotherapy of 20-30 Gy.

    Results: The limb-salvage rate was 91%, without local recurrences during a median follow-up of 84 months. Six patients died (55%); five from metastatic disease (45%). There were five long-term survivors with a median follow-up of 10 years. Three patients (60%) suffered serious late complications, resulting in disabilitating limb function.

    Conclusion: Although this approach is feasible as a limb-saving treatment for these unfavorable STS, long-term morbidity is high. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.

    Original languageEnglish
    Pages (from-to)15-19
    Number of pages5
    JournalRadiotherapy and Oncology
    Volume51
    Issue number1
    Publication statusPublished - Apr-1999

    Keywords

    • sarcoma
    • doxorubicin
    • radiation
    • tissue tolerance
    • morbidity
    • radiation injury
    • ISOLATED LIMB PERFUSION
    • POSTOPERATIVE RADIOTHERAPY
    • SAVING TREATMENT
    • EWINGS-SARCOMA
    • ADRIAMYCIN
    • MELPHALAN
    • THERAPY
    • SURGERY

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