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Clinical outcome after neoadjuvant thermoradiotherapy in high grade soft tissue sarcomas
Author(s) -
Scully Sean P.,
Oleson James R.,
Leopold Kenneth A.,
Samulski Thaddeus V.,
Dodge Richard,
Harrelson John M.
Publication year - 1994
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930570303
Subject(s) - medicine , radiation therapy , soft tissue sarcoma , soft tissue , neoadjuvant therapy , surgery , hyperthermia , regimen , survival rate , sarcoma , adjuvant therapy , oncology , cancer , chemotherapy , pathology , breast cancer
In the treatment of soft tissue sarcomas, hypothermia has been demonstrated to enhance tumor necrosis from radiation therapy. The current study reports the clinical course of patients treated with this neoadjuvant therapy regimen. Forty‐four patients with deep, undisturbed, nonmetastatic, high grade soft tissue sarcomas completed a neoadjuvant treatment protocol with combined hyperthermia and radiation therapy followed by wide surgical resection. Negative surgical margins were obtained in 40 patients. There was one local recurrence, thus yielding a local control rate of 97.5%. All other failures were either through regional lymphatic spread or pulmonary metastasis. As a group, the patients at 36 months had a 72% overall and a 58% disease‐free survival. The most common pathologic diagnosis was malignant fibrous histiocytoma (MFH), which demonstrated a 36‐month survival of 52% vs. 82% for others ( P =0.02). Tumor size was not prognostically significant for disease free or overall survival ( P =0.13). Those patients with surgical margins <1 cm had a significantly lover disease‐free survival and overall survival in a multivariate analysis ( P =0.02 and P =0.006, respectively). Overall survival did not correlate with either the number of hyperthermia treatments received or the amount of tumor necrosis. Although this neoadjuvant protocol results in excellent local control rates, overall survival rates are comparable to adjuvant therapy employing radiation alone. © 1994 Wiley‐Liss, inc.