Intra-arterial induction chemotherapy for soft tissue sarcomas

A. Azzarelli, V. Quagliuolo, P. Casali, S. Fissi, A. Gabuglia, P. Bignami, A. Santoro, S. Andreola, L. Gennari

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Abstract

One hundred-one patients were treated in our institution with intra-arterial preoperative adriamycin (i.a. ADR) for large soft tissue sarcomas of the extremities, 45% recurrent at entry. Of the 78 high grade evaluable patients 38% had clinical and 45% had pathological responses to chemotherapy. Limb conservative surgery was performed in 80% of cases, with about 10% improvement made possible by the preoperative treatment. The local recurrence rate was 29%, and 50% five-year actuarial survival with a median follow-up of 68 months. These poor results are related to the severe selection of high risk cases. The clinical parameter of response was highly predictive of survival: 63% versus 36% (p = 0.01) 5-year survival in the group of responders and non-responders, respectively, whereas the pathological parameter of response was not so predictive. The improved effect of delivering the drug intra-arterially is theoretically expected but not proved in our experience. The major practical effect of this induction chemotherapy is the selection of patients with better prognosis and the possibility of perform, in some cases, easier limb salvage procedures. The last regimen combining i.a. ADR+ i.v. Ifosfamide seems to provide little better but not yet significant results.

Original languageEnglish
Pages (from-to)67-70
Number of pages4
JournalAnnals of Oncology
Volume3
Issue numberSUPPL. 2
Publication statusPublished - 1992

Fingerprint

Induction Chemotherapy
Sarcoma
Doxorubicin
Survival
Extremities
Ifosfamide
Limb Salvage
Patient Selection
Recurrence
Drug Therapy
Pharmaceutical Preparations
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Azzarelli, A., Quagliuolo, V., Casali, P., Fissi, S., Gabuglia, A., Bignami, P., ... Gennari, L. (1992). Intra-arterial induction chemotherapy for soft tissue sarcomas. Annals of Oncology, 3(SUPPL. 2), 67-70.

Intra-arterial induction chemotherapy for soft tissue sarcomas. / Azzarelli, A.; Quagliuolo, V.; Casali, P.; Fissi, S.; Gabuglia, A.; Bignami, P.; Santoro, A.; Andreola, S.; Gennari, L.

In: Annals of Oncology, Vol. 3, No. SUPPL. 2, 1992, p. 67-70.

Research output: Contribution to journalArticle

Azzarelli, A, Quagliuolo, V, Casali, P, Fissi, S, Gabuglia, A, Bignami, P, Santoro, A, Andreola, S & Gennari, L 1992, 'Intra-arterial induction chemotherapy for soft tissue sarcomas', Annals of Oncology, vol. 3, no. SUPPL. 2, pp. 67-70.
Azzarelli, A. ; Quagliuolo, V. ; Casali, P. ; Fissi, S. ; Gabuglia, A. ; Bignami, P. ; Santoro, A. ; Andreola, S. ; Gennari, L. / Intra-arterial induction chemotherapy for soft tissue sarcomas. In: Annals of Oncology. 1992 ; Vol. 3, No. SUPPL. 2. pp. 67-70.
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AU - Azzarelli, A.

AU - Quagliuolo, V.

AU - Casali, P.

AU - Fissi, S.

AU - Gabuglia, A.

AU - Bignami, P.

AU - Santoro, A.

AU - Andreola, S.

AU - Gennari, L.

PY - 1992

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AB - One hundred-one patients were treated in our institution with intra-arterial preoperative adriamycin (i.a. ADR) for large soft tissue sarcomas of the extremities, 45% recurrent at entry. Of the 78 high grade evaluable patients 38% had clinical and 45% had pathological responses to chemotherapy. Limb conservative surgery was performed in 80% of cases, with about 10% improvement made possible by the preoperative treatment. The local recurrence rate was 29%, and 50% five-year actuarial survival with a median follow-up of 68 months. These poor results are related to the severe selection of high risk cases. The clinical parameter of response was highly predictive of survival: 63% versus 36% (p = 0.01) 5-year survival in the group of responders and non-responders, respectively, whereas the pathological parameter of response was not so predictive. The improved effect of delivering the drug intra-arterially is theoretically expected but not proved in our experience. The major practical effect of this induction chemotherapy is the selection of patients with better prognosis and the possibility of perform, in some cases, easier limb salvage procedures. The last regimen combining i.a. ADR+ i.v. Ifosfamide seems to provide little better but not yet significant results.

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