title: Adriamycin and cis-platinum as first-line treatment in unresectable locally advanced or metastatic adult soft-tissue sarcomas.
abstract: Standard chemotherapy in advanced adult soft-tissue sarcomas (STS) has not yet been established. We evaluated the efficacy and toxicity of the combination of adriamycin (ADR) and cis-platinum (CDDP) as first-line treatment in nonoperable locally advanced or metastatic adult STS. Thirty patients were treated with CDDP 100 mg/m2 on day 1 and ADR 75 mg/m2 equally divided on days 1 to 3, every 3 weeks for 6 cycles. Patients were evaluated for response, toxicity, and survival, while resectability of residual disease was also assessed after the third cycle and the end of chemotherapy. No complete response was observed. Five patients (16.7%, 95% CI: 2.5%-31%) achieved partial response, 16 patients (53.3%, 95% CI: 34%-72%) had stable disease and 9 patients (30%, 95% CI: 13%-47%) had progressive disease. The overall median survival was 11.5 months (range, 4-96 months), and the median time to disease progression was 6 months (range, 0-96 months). Furthermore, two patients with PR and six patients with stable disease underwent further surgery followed by radiotherapy in four of them. At present, 5 patients remain free of relapse for 96, 90, 72, 60, and 48 months, respectively. Treatment-related toxicity was acceptable, with moderate myelosuppression and alopecia as the main adverse events. The ADR/CDDP regimen was well tolerated, but it did not achieve a high response rate. However, patients with resectable disease after chemotherapy achieved long-term survival. Further studies are needed to evaluate the role of combined-modality treatments in the management of patients with advanced STS.
authors.affiliation: Division of Oncology, Department of Medicine, University Hospital of Patras, Rion, Greece. kalofon@med.upatras.gr
authors.forename: Haralabos P
authors.initials: HP
authors.lastname: Kalofonos
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Bafaloukos
authors.forename: Theodoros G
authors.initials: TG
authors.lastname: Kourelis
authors.forename: Michalis V
authors.initials: MV
authors.lastname: Karamouzis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Megas
authors.forename: Grigorios
authors.initials: G
authors.lastname: Iconomou
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Tsiata
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Dimitropoulos
authors.forename: Paris
authors.initials: P
authors.lastname: Kosmidis
authors.forename: E
authors.initials: E
authors.lastname: Lampiris
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012509:Sarcoma / Q000188:drug therapy* / Q000556:secondary; D016019:Survival Analysis
chemical_list: D004317:Doxorubicin; D002945:Cisplatin