Long-term results of preoperative intra-arterial doxorubicin combined with neoadjuvant radiotherapy, followed by extensive surgical resection for locally advanced soft tissue sarcomas of the extremities.
OBJECTIVE
In the 1980s a combined modality therapy of intraarterial doxorubicin, neoadjuvant radiotherapy and surgery was initiated at the Groningen University Hospital as a limb-saving treatment for locally advanced, primarily irresectable high-grade soft tissue sarcomas (STS) of the extremities. This study presents the short- and long-term results.


METHODS
Between 1983 and 1987, 11 patients were treated with intraarterial doxorubicin, preoperative radiotherapy (10 x 3.5 Gy) and surgical resection. Non-radical resections received additional postoperative radiotherapy of 20-30 Gy.


RESULTS
The limb-salvage rate was 91%, without local recurrences during a median follow-up of 84 months. Six patients died (55%); five from metastatic disease (45%). There were five long-term survivors with a median follow-up of 10 years. Three patients (60%) suffered serious late complications, resulting in disabilitating limb function.


CONCLUSIONS
Although this approach is feasible as a limb-saving treatment for these unfavorable STS, long-term morbidity is high.
Nijhuis
P H
PH
Department of Surgical Oncology, Groningen University Hospital, The Netherlands.
Pras
E
E
Sleijfer
D T
DT
Molenaar
W M
WM
Koops
H S
HS
Hoekstra
H J
HJ
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage* / Q000627:therapeutic use; D005121:Extremities; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D004317:Doxorubicin