Neoadjuvant treatment in conservative surgery of peripheral sarcomas.
Twenty-five patients with soft-tissue and bony sarcomas of the head and neck and limbs were treated by local neoadjuvant therapy. It consisted of 90 mg of Adriamycin infused intra-arterially over 3 days into a vessel feeding the involved area and 30 Gy of radiotherapy given over 10 days; this was followed by a complete resection of the sarcoma 4 to 6 weeks later. All the tumors were associated with a high risk of local recurrence; eight were locally recurrent and the remainder were stage II to stage IV tumours. Serious local complications were seen in 4% of the patients. This rate compares well with other higher dose neoadjuvant regimens (35 Gy over 10 days), which are associated with a 35% local complication rate. Follow-up at a mean of 30 months demonstrated no local recurrence. All limbs were spared. Long-term morbidity was negligible. No effect on systemic control is suggested; only 63% of the patients were free of systemic disease. This report substantiates other similar experiences supporting neoadjuvant therapy followed by resection as the treatment of choice for local control of sarcomas.
Tom Baker Cancer Centre, Calgary, Alta.
W J
WJ
Temple
J A
JA
Russell
K
K
Arthur
N S
NS
Schachar
T S
TS
Crabtree
M A
MA
Anderson
D001859:Bone Neoplasms / Q000188:drug therapy*; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage* / Q000009:adverse effects; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D012509:Sarcoma / Q000188:drug therapy* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000188:drug therapy*
D004317:Doxorubicin