Results of surgery and radio-hyperthermo-chemotherapy for patients with soft-tissue sarcoma.
BACKGROUND
Between 1990 and 1999, we performed radio-hyperthermo-chemotherapy (RHC) in 44 patients with high-grade soft-tissue sarcomas of the limbs.


METHODS
Radiotherapy involved the delivery of radiation at a dose of 2 Gy once daily on 16 days, to give a total dose of 32 Gy. Hyperthermia was conducted once a week, with a total of five sessions. Chemotherapy was performed by implanting a reservoir and administering cisplatin (3 mg/kg) three times, and pinorubin (an adriamycin derivative; 1 mg/kg) twice by intra-arterial infusion, at weekly intervals. These drugs were administered alternately during hyperthermia sessions.


RESULTS
Tumor shrinkage was observed in 98% (43/44) of the patients. Of the 36 patients with M0 tumors, 30 were disease-free at final follow-up, 2 had no evidence of disease, 1 was alive with disease, and 3 had died of the disease. Amputation was required only in the first patient, and the affected limb was preserved in the other 43 patients. The surgical margin was wide in 9 patients and marginal in 29 patients, and intralesional excision was performed in 5 patients. There was recurrence in only 1 of the 44 patients.


CONCLUSIONS
RHC is currently the most potent and relatively safe treatment method for high-grade soft-tissue sarcomas that is available clinically.
Otsuka
T
T
Department of Orthopaedic Surgery, Nagoya City University Medical School, 1 Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan. t.otsuka@med.nagoya-cu.ac.jp
Yonezawa
M
M
Kamiyama
F
F
Matsushita
Y
Y
Matsui
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000031:analogs & derivatives; D005121:Extremities; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008875:Middle Aged; D012509:Sarcoma / Q000628:therapy*
D004317:Doxorubicin; D002945:Cisplatin