Radiotherapy in soft-tissue sarcoma of the extremities

Correa, Raquel; Gómez-Millán, Jaime; Lobato, M.; Fernandez, Ana Isabel Lavado; Ordóñez, Rafael; Castro, C.; Lupianez, Y.; Medina, J. A.

doi:10.1007/s12094-018-1848-x

Cited by 14 publications

(18 citation statements)

References 57 publications

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“…The adjuvant and the neoadjuvant approaches have been compared in a randomized clinical trial by et al, whose results showed that parameters such as tumor size and location should be considered at the moment of clinical indication [6]. No further clarification can be derived from currently available national guidelines, specifically regarding the optimal timing and modality of adjuvant treatment is provided [1,15].…”

Section: Discussionmentioning

confidence: 99%

“…Acute and late toxicity were graded according to the Common Terminology Criteria for Adverse Events (CTCAE 4.0) scoring system [12]. Pain was evaluated by the Numerical Rating Scale (NRS) score system (0=no symptoms, 10=worst degree of symptoms) and furtherly categorized as absent (0), light (1-3), moderate [10][11][12][13] or severe [6,14,15].…”

Section: Oncologistmentioning

confidence: 99%

See 1 more Smart Citation

Adjuvant radiotherapy treatment for soft tissue sarcoma of extremities and trunk. A retrospective mono-institutional analysis

Spoto¹,

Vavassori²,

Dicuonzo³

et al. 2021

neo

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Soft tissue sarcomas (STS) are uncommon, heterogeneous malignant tumors of mesodermal origin. Other than conservative surgery (CS), neoadjuvant or adjuvant radiotherapy (RT) is recommended when the risk of local recurrence is high. The aim of this study is to present our Institutional experience in adjuvant RT for treatment of STS of extremities and trunk (with either brachytherapy (BRT), external beam RT (EBRT), or both) and to provide an insight of toxicity and oncological outcomes for each RT modality. According to the RT treatment approach, patients were divided into three categories: 1) BRT alone; 2) EBRT alone; 3) combined BRT+EBRT. Differences among the three groups were assessed by the Chi-squared test. Patients' follow-up was performed every 6 months for the first two years after the end of RT and then once a year. Data from 90 patients were analyzed. The overall 3-year distant relapse-free survival (DRFS), progression-free survival (PFS) and overall survival (OS) were 84%, 80%, and 97%, respectively. Acute erythema was the most frequent side effect, although severe grade 3 toxicity was present in 5 patients. Chronic toxicity of any grade was reported in 14 patients. The incidence of chronic toxicity did not show any association with treatment modality. Multivariate analysis suggested a significant correlation between acute toxicity and tumor size, RT modality, and RT dose. In conclusion, good local control and toxicity profile were observed, despite negative patients' selection at baseline. Further investigation on wider series is warranted in order to define the optimal combination with systemic therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Oncologistmentioning

confidence: 99%

Adjuvant radiotherapy treatment for soft tissue sarcoma of extremities and trunk. A retrospective mono-institutional analysis

Spoto¹,

Vavassori²,

Dicuonzo³

et al. 2021

neo

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“…El papel de la radioterapia tanto preoperatoria como posoperatoria es un punto que genera controversia 19 . El control local y la supervivencia global no se ven influenciados por el momento en el que se realice la radioterapia.…”

Section: Discussionunclassified

“…The role of preoperative and postoperative radiotherapy is controversial 19 . Local control and overall survival are not influenced by the moment radiotherapy is performed.…”

Section: Discussionmentioning

confidence: 99%

Resultados del tratamiento quirúrgico de sarcomas de partes blandas en adultos

Loccisano¹,

Montesinos²,

Brégoli³

et al. 2019

Rev Argent Cirug

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Background: Soft-tissue sarcomas (STS) are rare mesenchymal tumors with several histologic subtypes and different clinical patterns. Objective: The aim of this study was to describe the clinical and pathological characteristics and surgical outcomes of a series of patients with STS. Material and methods: The clinical records of 2403 undergoing surgery between October 2014 and April 2018 were retrospectively reviewed. Twenty-two patients (0.91%) presented STS. Results: Mean age was 52 years (range: 19-92) and 13 (59%) were women. The tumors were located in the lower extremities in 12 cases, head and neck in five, trunk in three and upper extremities in two. Fourteen cases (63.6%) were high-grade tumors. Pleomorphic sarcoma was the most common histologic type (32%) followed by synovial sarcoma (18%), liposarcoma (14%), and other types (36%). All the tumors were completely resected and five patients (35.7%) required amputation, four in the lower extremity and on in the upper extremity. Different reconstructive procedures were performed accor- ding to tumor size and location, including three free flaps. Those patients with high-grade sarcomas or with positive margins received postoperative radiotherapy. After a mean follow-up of 16 months, six patients presented local recurrences and four patients had synchronous metastatic disease in the lungs; all these patients had high-grade tumors. Overall survival was 86.4%. Conclusion: STS are rare and invasive neoplasms, widely distributed, requiring aggressive and occa- sionally complex surgical procedures. It is necessary to consider adjuvant treatments in selected cases and to maintain regular follow-up due to the high rate of recurrences and distant metastases.

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“…Surgical resection remains the mainstay of primary treatment 3. Radiation therapy frequently plays a role in the neoadjuvant, adjuvant, or palliative settings.…”

Section: Introductionmentioning

confidence: 99%

<p>Spotlight on aldoxorubicin (INNO-206) and its potential in the treatment of soft tissue sarcomas: evidence to date</p>

Cranmer¹

2019

OTT

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Anthracyclines, and doxorubicin in particular, remain a mainstay of sarcoma therapy. Despite modest activity and significant toxicities, no cytotoxic monotherapy has yet yielded superior overall survival over doxorubicin for therapy of advanced soft tissue sarcomas in a randomized trial. Similarly, combination regimens have also been unable to overcome doxorubicin in terms of overall survival. Strategies to ameliorate the most prominent side effect of doxorubicin, cardiotoxicity, are available, but their use in sarcoma patients has been limited. Aldoxorubicin is a prodrug consisting of doxorubicin with a covalent linker. It binds rapidly after intravenous infusion to cysteine-34 of human serum albumin. The drug–albumin conjugate is preferentially retained in tumor tissue, with uptake into tumoral cells. At physiologic pH, the complex is stable. Hydrolysis can occur under the acidic conditions of the endocytic lysosome, releasing doxorubicin. Doxorubicin then distributes to various cellular compartments, including Golgi, mitochondrion, and nucleus, with subsequent cytotoxic effects. Aldoxorubicin has demonstrated in vitro and in vivo activities in both cancer model systems and human xenografts. Preclinical models also support its decreased cardiac effects vs doxorubicin, although such promising results require formal comparison at efficacy equivalent doses of the two drugs. Phase I studies confirmed the tolerability of aldoxorubicin in humans. Clinical cardiotoxicity was not observed, but molecular and subclinical cardiac effects could be demonstrated. A Phase II study in treatment-naïve, advanced sarcoma patients demonstrated improved progression-free survival and response rate over doxorubicin, although no survival benefit was evident. A Phase III study of aldoxorubicin vs investigator’s choice from a panel of chemotherapy regimens in the salvage setting was unable to demonstrate a benefit in progression-free or overall survival in the entire population. Progression-free survival in L-sarcomas (leiomyosarcomas and liposarcomas) was documented. While evidence of subclinical cardiac effects was seen in a small proportion of aldoxorubicin-treated patients, data from both the Phase II and III studies indicated a favorable cardiotoxicity profile vs doxorubicin. Despite the negative results from this Phase III study, the importance of anthracycline therapy in sarcoma management merits further investigation of the potential role of aldoxorubicin in this indication. Other avenues for progress include identification of sensitive histologies and biomarkers of activity, exploration of clinical niches without proven standard therapies, and exploration of alternate dosing strategies.

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Radiotherapy in soft-tissue sarcoma of the extremities

Cited by 14 publications

References 57 publications

Adjuvant radiotherapy treatment for soft tissue sarcoma of extremities and trunk. A retrospective mono-institutional analysis

Adjuvant radiotherapy treatment for soft tissue sarcoma of extremities and trunk. A retrospective mono-institutional analysis

Resultados del tratamiento quirúrgico de sarcomas de partes blandas en adultos

<p>Spotlight on aldoxorubicin (INNO-206) and its potential in the treatment of soft tissue sarcomas: evidence to date</p>

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