Neoadjuvant chemotherapy and radiotherapy for large extremity soft-tissue sarcomas

DeLaney, Thomas F.; Spiro, Ira J.; Suit, Herman D.; Gebhardt, Mark C.; Hornicek, Francis J.; Mankin, Henry J.; Rosenberg, Andrew; Rosenthal, Daniel I.; Miryousefi, Fariba; Ancukiewicz, Marcus; Harmon, David C.

doi:10.1016/s0360-3016(03)00186-x

Cited by 282 publications

(184 citation statements)

References 16 publications

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…However, the pathological response rate (defined as <10% vital cells in our study) was lower than in many other series [22,48,50]. This might be due to the omission of preoperatively applied radiation therapy or the different chemotherapy schedule in our study.…”

Section: Discussioncontrasting

confidence: 82%

“…In our study using preoperative chemotherapy alone with radiation applied intra-and postoperatively, we observed a moderate clinical response rate, which was in the range reported by other groups using preoperative chemotherapy, chemo-hyperthermia or chemoradiation (11-29%) [22,50,53]. However, the pathological response rate (defined as <10% vital cells in our study) was lower than in many other series [22,48,50].…”

Section: Discussionsupporting

confidence: 48%

“…Several non-randomized trials showed high rates of histological response [48,49] up to~50%, which correlated with outcome including overall survival [48]. Delaney et al [50] and Mullen et al [51] also described excellent results in a highly unfavourable patient group after treatment with an intensified regimen of neoadjuvant chemoradiation at Massachusetts General Hospital (MGH), although considerable rates of toxicity were observed. Further on, this approach resulted in significant improvements in terms of local control, freedom from distant metastases, disease-free and overall survival compared to a historical control group treated without chemotherapy, highly indicating that a neoadjuvant approach might be beneficial.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Excellent Local Control With IOERT and Postoperative EBRT in High-Grade Extremity Sarcoma: Results From a Subgroup Analysis of a Prospective Trial

Roeder¹,

Schmitt²,

Lehner³

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

show abstract

Section: Discussioncontrasting

confidence: 82%

Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Excellent Local Control With IOERT and Postoperative EBRT in High-Grade Extremity Sarcoma: Results From a Subgroup Analysis of a Prospective Trial

Roeder¹,

Schmitt²,

Lehner³

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

show abstract

“…38 Chemoradiotherapy, a combination of preoperative (intraarterial or intravenous) chemotherapy and radiotherapy, was shown to provide excellent local control rates and improved overall survival with acceptable toxicity both in small exploring studies 39 and in a comparison with a historical control group. 40 However, this treatment option remains investigational and the results of randomized trials are pending. Moreover, to compare chemoradiotherapy with ILP is difficult, as the tumors are primarily resectable in the first case, whereas they are generally not in the second.…”

Section: Progression and Survivalmentioning

confidence: 99%

Outcome and prognostic factor analysis of 217 consecutive isolated limb perfusions with tumor necrosis factor‐α and melphalan for limb‐threatening soft tissue sarcoma

Grünhagen

Wilt

Graveland

et al. 2006

Cancer

125

View full text Add to dashboard Cite

Objective The serum of most neuromyelitis optica (NMO) patients contains autoantibodies (NMO‐IgGs) directed against the aquaporin‐4 (AQP4) water channel located on astrocyte foot processes in the perivessel and subpial areas of the brain. Our objectives were to determine the source of central nervous system (CNS) NMO‐IgGs and their role in disease pathogenesis. Methods Fluorescence‐activated cell sorting and single‐cell reverse transcriptase polymerase chain reaction were used to identify overrepresented plasma cell immunoglobulin (Ig) sequences in the cerebrospinal fluid (CSF) of an NMO patient after a first clinical attack. Monoclonal recombinant antibodies (rAbs) were generated from the paired heavy and light chain sequences and tested for target specificity and Fc effector function. The effect of CSF rAbs on CNS immunopathology was investigated by delivering single rAbs to rats with experimental autoimmune encephalomyelitis (EAE). Results Repertoire analysis revealed a dynamic, clonally expanded plasma cell population with features of an antigen‐targeted response. Using multiple independent assays, 6 of 11 rAbs generated from CSF plasma cell clones specifically bound to AQP4. AQP4‐specific rAbs recognized conformational epitopes and mediated both AQP4‐directed antibody‐dependent cellular cytotoxicity and complement‐mediated lysis. When administered to rats with EAE, an AQP4‐specific NMO CSF rAb induced NMO immunopathology: perivascular astrocyte depletion, myelinolysis, and complement and Ig deposition. Interpretation Molecular characterization of the CSF plasma cell repertoire in an early NMO patient demonstrates that AQP4‐specfic Ig is synthesized intrathecally at disease onset and directly contributes to CNS pathology. AQP4 is now the first confirmed antigenic target in human demyelinating disease. Ann Neurol 2009;66:617–629

show abstract

“…[18][19][20][21] Ifosfamide is a nitrogen mustard alkylating agent with proven activity in soft tissue sarcoma when employed as a single agent or in combination with an anthracycline. Previous reports have suggested a benefit of single-agent ifosfamide and radiation therapy for unresectable soft tissue sarcoma.…”

Section: Discussionmentioning

confidence: 99%

Pathologic Complete Response of a Malignant Peripheral Nerve Sheath Tumor in the Lung Treated With Neoadjuvant Ifosfamide and Radiation Therapy

Cuneo

Riedel

Dodd

et al. 2012

JCO

View full text Add to dashboard Cite

A 63-year old woman presented in November 2007 with a productive cough, dyspnea, and hoarseness. She had been previously evaluated by her primary care physician and treated with two courses of antibiotics for pneumonia without significant improvement. Her past medical history was unremarkable, with the exception of a 60 pack-year smoking history. Physical examination was significant for decreased breath sounds in the left upper hemithorax. A chest x-ray identified a 10-cm mass in the left upper lobe, with tracheal compression ( Fig 1A). The patient underwent a computed tomography (CT) scan of the chest, which revealed a 10-cm necrotic mass abutting and invading into the aortopulmonary window, with associated left hilar lymphadenopathy indicative of a primary lung cancer.A CT-guided biopsy was performed. The tumor had the histopathological appearance of a high-grade sarcoma (Fig 2A). Immunohistochemistry was negative for cytokeratin (AE1/AE3), S-100, smooth muscle actin, desmin, epithelial membrane antigen, and CD34, but positive for vimentin, CD56, CD57, collagen 4, and neurofilament. These results were consistent with a high-grade, malignant, peripheral nerve sheath tumor. A staging positron emission tomography (PET)/CT scan showed no evidence of extrapulmonary disease (Fig 1B).The patient was subsequently referred to our multidisciplinary sarcoma center and was evaluated by a multidisciplinary team, which

show abstract

Neoadjuvant chemotherapy and radiotherapy for large extremity soft-tissue sarcomas

Cited by 282 publications

References 16 publications

Excellent Local Control With IOERT and Postoperative EBRT in High-Grade Extremity Sarcoma: Results From a Subgroup Analysis of a Prospective Trial

Excellent Local Control With IOERT and Postoperative EBRT in High-Grade Extremity Sarcoma: Results From a Subgroup Analysis of a Prospective Trial

Outcome and prognostic factor analysis of 217 consecutive isolated limb perfusions with tumor necrosis factor‐α and melphalan for limb‐threatening soft tissue sarcoma

Pathologic Complete Response of a Malignant Peripheral Nerve Sheath Tumor in the Lung Treated With Neoadjuvant Ifosfamide and Radiation Therapy

Contact Info

Product

Resources

About