Adjuvant CYVADIC chemotherapy for adult soft tissue sarcoma--reduced local recurrence but no improvement in survival: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group.

Bramwell, Vivien; Rouëssé, Jacques; Steward, William P.; Santoro, Armando; Schraffordt-Koops, H; Buesa, J. M.; Ruka, W.; Priario, Julio C; Wagener, T.; Burgers, M

doi:10.1200/jco.1994.12.6.1137

Cited by 214 publications

(91 citation statements)

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“…A response rate of 45% and a 5-year overall survival rate of 66% for patients with Stage III disease was reported [24]. In one European trial, adjuvant chemotherapy in the form of cyclophosphamide, vincristine, doxorubicin, and dacarbazine (CYVADIC) reduced local recurrence but not overall survival, similar to our study [4]. One theory regarding how chemotherapy might affect local control is that chemotherapy may affect actively dividing cells at the margins of tumors [19].…”

Section: Discussionsupporting

confidence: 85%

Should High-grade Extraosseous Osteosarcoma Be Treated With Multimodality Therapy Like Other Soft Tissue Sarcomas?

Fan

Patel

Lewis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Extraosseous osteosarcoma is rare, and the most appropriate therapy is unclear because there are few studies regarding its treatment. The effectiveness of radiation and chemotherapy remains uncertain owing to conflicting results in previous reports. Questions/purposes To review our experience with contemporary multimodality treatment, we asked: (1) What is the disease-specific survival and local relapse-free survival? (2) Does American Joint Commission on Cancer (AJCC) stage, tumor size, or location relate to disease outcome? (3) Does radiation therapy improve local control or survival? (4) Do doxorubicin and ifosfamide improve local control or survival? Methods Between 1990 and 2012, we treated 40 patients for localized, high-grade extraosseous osteosarcoma. In this retrospective study, we could determine the status of 36 patients (90%) either to death or for a minimum of 24 months of followup; four (10%) were lost to followup before 24 months. There were 11 patients with AJCC Stage IIA and 25 with Stage III disease. All patients underwent wide surgical excision. Of the patients with Stage IIA disease, four received radiation and none received chemotherapy. Of the patients with Stage III disease, six received radiation, seven were treated with chemotherapy, and six received radiation and chemotherapy. During the study period, high-dose doxorubicin and ifosfamide was the preferred chemotherapy regimen for patients younger than 60 years with normal cardiac and renal function. Local relapse-free survival and disease-specific survival were determined by Kaplan-Meier analysis using a prospectively maintained institutional database supplemented by information from the institutional tumor registry. The Cox proportional hazard model was used to determine the effect of various factors on local recurrence and patient survival.One of the authors certifies that he (SP), or a member of his or her immediate family, has or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from CytRx (Los Angeles, CA, USA), an amount of less than 10,000 USD from Janssen Pharmaceuticals/Johnson & Johnson (Titusville, NJ, USA), and an amount of USD 10,000-USD 100,000 from Novartis (Basel, Switzerland). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. Results At 5 years, local relapse-free survival was 47% (95% CI, 27%-64%), and disease-spe...

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Section: Discussionsupporting

confidence: 85%

Should High-grade Extraosseous Osteosarcoma Be Treated With Multimodality Therapy Like Other Soft Tissue Sarcomas?

Fan

Patel

Lewis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…The regimens that were applied are listed in Table 1. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] High-dose chemotherapy (HDC) with hematopoietic stem cell rescue was received by 51 patients, including 48 patients who received autologous peripheral blood stem cell transfusion (PBSCT) and 3 patients who underwent autologous bone marrow transplantation.…”

Section: Treatmentmentioning

confidence: 99%

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Obata

Ueda

Kawai

et al. 2007

Cancer

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BACKGROUND.Ewing sarcoma family of tumors (ESFT) of bone is extremely rare in Japan. The objectives of the current study were to assess the clinical outcome and prognostic factors of patients with ESFT of bone in Japan and to compare them between Euro‐American and Japanese populations.METHODS.The authors conducted a retrospective analysis of 243 patients who were treated for ESFT of bone in Japan between 1981 and 2003. Local therapy was surgery in 35% of patients, surgery combined with radiotherapy in 40% of patients, radiotherapy alone in 22% of patients, and no local treatment in 3% of patients. All but 3 patients received various regimens of multidrug chemotherapy.RESULTS.The median patient age was 16 years. The primary disease sites were the trunk in 53% of patients and the extremities in 47% of patients. Forty‐one patients had metastases at presentation. The median follow‐up was 66 months. A univariate survival analysis demonstrated that patients who had metastases at presentation, primary site in the trunk, age ≥16 years, tumor size ≥10 cm, tumor that responded poorly to induction chemotherapy, and local treatment with radiotherapy alone had a significantly worse event‐free survival (EFS). A multivariate analysis further verified that the former 3 factors were significant adverse prognostic factors. Of 201 patients with localized disease, 45 patients who received current chemotherapy regimens that included ifosfamide and etoposide had a significantly better 5‐year EFS rate (67.6%) compared with other patients.CONCLUSIONS.The clinical outcome of patients with localized ESFT of bone in Japan has improved markedly with the use of current chemotherapy regimens that include ifosfamide and etoposide and has become comparable to the outcomes observed in other major series of Euro‐American patients. The prognostic factors are also almost identical. Cancer 2007 © 2007 American Cancer Society.

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“…If the tumor is unresectable, neoadjuvant therapies (radiotherapy, chemoradiation, chemotherapy) are recommended primarily, even if some authors have not found any improvement in overall survival. 8 Tumors that become resectable after preoperative treatment can be treated with surgery. Otherwise, definitive radiotherapy is recommended.…”

Section: Discussionmentioning

confidence: 99%

Myxoid liposarcoma of the hand – A rare entity

Zarâa¹,

Haboubi²,

Bessalah³

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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Adjuvant CYVADIC chemotherapy for adult soft tissue sarcoma--reduced local recurrence but no improvement in survival: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group.

Abstract: Adjuvant chemotherapy with CYVADIC cannot be recommended outside the context of a clinical trial. Experience from this study has been used to plan a trial of neoadjuvant chemotherapy with doxorubicin/ifosfamide, which is currently in progress.

Cited by 214 publications

References 24 publications

Should High-grade Extraosseous Osteosarcoma Be Treated With Multimodality Therapy Like Other Soft Tissue Sarcomas?

Should High-grade Extraosseous Osteosarcoma Be Treated With Multimodality Therapy Like Other Soft Tissue Sarcomas?

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Myxoid liposarcoma of the hand – A rare entity

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