Concomitant chemo-radiotherapy in the treatment of locally advanced and/or metastatic soft tissue sarcomas: Experience of the National Cancer Institute of Genoa

Salvatore Toma, Giuseppe Canavese, Andrea Grimaldi, Giambattista Ravera, Donatella Ugolini, Pierluigi Percivale, Fausto Badellino

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Abstract

Previous in vitro and in vivo studies showed a synergistic effect of concomitant doxorubicin and radiotherapy in a variety of solid tumors. From 1988 to 2000, we have investigated in a pilot study and then in a phase II study the efficacy of a concomitant doxorubicin radiotherapy treatment in patients with advanced and/or metastatic soft tissue sarcomas (STS). We enrolled and treated a group of 115 patients with advanced STS, with metastases (61%), frequently pretreated (59%), predominantly G2/G3 (84%). Doxorubicin was administered by continuous infusion at a dose of 12 mg/m2/day over 5 consecutive days concomitantly with radiotherapy; treatment was given on ambulatory basis at 2-week intervals with support of granulocytes colony stimulating factors (GCSF). In the whole group of 115 patients a clinical objective response (ORs) rate of 67% was obtained, with 11% complete and 56% partial responses. No patient progressed while on therapy, except one who progressed in non-irradiated metastatic tumor. Treatment (median 3 cycles) was well tolerated with no WHO grade 3 toxicity (apart from alopecia) and no acute or chronic cardiotoxicity. Thirty-nine responder patients underwent surgery (24 primary tumors, 10 relapses, 5 relapses plus isolated lung metastases). The median survival time(s) was 29 months in the whole series and over 50 months in responder patients. A multivariate analysis showed a positive association between survival and sex (HR=1.8; CI 95%, 1.0-3.4), performance status (HR=2.1; CI 95%, 1.1-4.0), ORs (HR=7.9; CI 95%, 3.5-18.1) and surgery (HR=8.8; CI 95%, 2.1-35.9). Low toxicity, high OR rate and positive survival time trend make the concomitant chemo-radiotherapy an efficacious approach for advanced STS.

Original languageEnglish
Pages (from-to)641-647
Number of pages7
JournalOncology Reports
Volume10
Issue number3
Publication statusPublished - May 2003

Fingerprint

National Cancer Institute (U.S.)
Sarcoma
Radiotherapy
Doxorubicin
Therapeutics
Neoplasm Metastasis
Recurrence
Neoplasms
Survival
Alopecia
Granulocyte Colony-Stimulating Factor
Multivariate Analysis
Survival Rate
Lung

Keywords

  • Clinical trials phase II
  • Doxorubicin
  • Human radiotherapy
  • Neoplasm metastasis
  • Sarcoma
  • Soft tissue neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Toma, S., Canavese, G., Grimaldi, A., Ravera, G., Ugolini, D., Percivale, P., & Badellino, F. (2003). Concomitant chemo-radiotherapy in the treatment of locally advanced and/or metastatic soft tissue sarcomas: Experience of the National Cancer Institute of Genoa. Oncology Reports, 10(3), 641-647.

Concomitant chemo-radiotherapy in the treatment of locally advanced and/or metastatic soft tissue sarcomas : Experience of the National Cancer Institute of Genoa. / Toma, Salvatore; Canavese, Giuseppe; Grimaldi, Andrea; Ravera, Giambattista; Ugolini, Donatella; Percivale, Pierluigi; Badellino, Fausto.

In: Oncology Reports, Vol. 10, No. 3, 05.2003, p. 641-647.

Research output: Contribution to journalArticle

Toma, S, Canavese, G, Grimaldi, A, Ravera, G, Ugolini, D, Percivale, P & Badellino, F 2003, 'Concomitant chemo-radiotherapy in the treatment of locally advanced and/or metastatic soft tissue sarcomas: Experience of the National Cancer Institute of Genoa', Oncology Reports, vol. 10, no. 3, pp. 641-647.
Toma, Salvatore ; Canavese, Giuseppe ; Grimaldi, Andrea ; Ravera, Giambattista ; Ugolini, Donatella ; Percivale, Pierluigi ; Badellino, Fausto. / Concomitant chemo-radiotherapy in the treatment of locally advanced and/or metastatic soft tissue sarcomas : Experience of the National Cancer Institute of Genoa. In: Oncology Reports. 2003 ; Vol. 10, No. 3. pp. 641-647.
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abstract = "Previous in vitro and in vivo studies showed a synergistic effect of concomitant doxorubicin and radiotherapy in a variety of solid tumors. From 1988 to 2000, we have investigated in a pilot study and then in a phase II study the efficacy of a concomitant doxorubicin radiotherapy treatment in patients with advanced and/or metastatic soft tissue sarcomas (STS). We enrolled and treated a group of 115 patients with advanced STS, with metastases (61{\%}), frequently pretreated (59{\%}), predominantly G2/G3 (84{\%}). Doxorubicin was administered by continuous infusion at a dose of 12 mg/m2/day over 5 consecutive days concomitantly with radiotherapy; treatment was given on ambulatory basis at 2-week intervals with support of granulocytes colony stimulating factors (GCSF). In the whole group of 115 patients a clinical objective response (ORs) rate of 67{\%} was obtained, with 11{\%} complete and 56{\%} partial responses. No patient progressed while on therapy, except one who progressed in non-irradiated metastatic tumor. Treatment (median 3 cycles) was well tolerated with no WHO grade 3 toxicity (apart from alopecia) and no acute or chronic cardiotoxicity. Thirty-nine responder patients underwent surgery (24 primary tumors, 10 relapses, 5 relapses plus isolated lung metastases). The median survival time(s) was 29 months in the whole series and over 50 months in responder patients. A multivariate analysis showed a positive association between survival and sex (HR=1.8; CI 95{\%}, 1.0-3.4), performance status (HR=2.1; CI 95{\%}, 1.1-4.0), ORs (HR=7.9; CI 95{\%}, 3.5-18.1) and surgery (HR=8.8; CI 95{\%}, 2.1-35.9). Low toxicity, high OR rate and positive survival time trend make the concomitant chemo-radiotherapy an efficacious approach for advanced STS.",
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