Treatment of primary, recurrent or inadequately resected high-risk soft-tissue sarcomas (STS) of adults: results of a phase II pilot study (RHT-95) of neoadjuvant chemotherapy combined with regional hyperthermia

The efficacy of thermochemotherapy in adult patients with primary, recurrent or inadequately resected non-metastatic high-risk soft-tissue sarcomas (STS) was assessed. 54 patients were prospectively treated with four cycles of etoposide, ifosfamide and doxorubicin (EIA) combined with regional hypert...

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Bibliographic Details
Published in:European journal of cancer (1990) 2001-09, Vol.37 (13), p.1609-1616
Main Authors: Wendtner, C.-M., Abdel-Rahman, S., Baumert, J., Falk, M.H., Krych, M., Santl, M., Hiddemann, W., Issels, R.D.
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Chemotherapy, Adjuvant - methods
Cohort Studies
Disease-Free Survival
Doxorubicin - administration & dosage
Etoposide - administration & dosage
Female
High risk
Humans
Hyperthermia, Induced - methods
Ifosfamide - administration & dosage
Induced hyperthermia. Cryotherapy
Local failure-free survival
Male
Medical sciences
Middle Aged
Neoplasm Recurrence, Local - therapy
Overall survival
Pilot Projects
Prospective Studies
Radiotherapy, Adjuvant - methods
Regional hyperthermia (RHT)
Risk Factors
Sarcoma - therapy
Soft-tissue sarcoma
Thermochemotherapy
Treatment Outcome
Treatment with physical agents
Treatment. General aspects
Tumors
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Summary:The efficacy of thermochemotherapy in adult patients with primary, recurrent or inadequately resected non-metastatic high-risk soft-tissue sarcomas (STS) was assessed. 54 patients were prospectively treated with four cycles of etoposide, ifosfamide and doxorubicin (EIA) combined with regional hyperthermia (RHT) followed by surgery, another four cycles of EIA without RHT and external beam radiation. The objective response rate was 16% and at a median follow-up time of 57 months, the 4-year estimated rates of local failure-free survival (LFFS), distant metastasis-free survival (DMFS), event-free survival (EFS) and overall survival (OS) were 59% (95% confidence interval (CI) 45–73%), 59% (95% CI 44–73%), 26% (95% CI 14–38%) and 40% (95% CI 27–53%), respectively. OS was in favour of patients responding to neoadjuvant treatment (P=0.073). In comparison to a preceding phase II study including pre- and postsurgical thermochemotherapy (RHT-91), at a 4-year follow-up the RHT-95 study cohort showed an inferior LFFS rate (P=0.027), but this did not affect DMFS (P=0.558) or OS (P=0.126). Hence, postsurgical thermochemotherapy seems critical for local tumour control without affecting survival.
ISSN:0959-8049
1879-0852
DOI:10.1016/S0959-8049(01)00191-5