Large institutional experience with dose-intensive chemotherapy and stem cell support in the management of sarcoma patients.
BACKGROUND
The prognosis of patients with advanced sarcoma remains poor. Whether high-dose chemotherapy with stem cell support improves the long-term outcome for these patients or not is controversial.


METHODS
We present a large institutional experience of sarcoma patients treated with this therapy option. Thirty-eight patients with bone (n = 17) and soft tissue sarcomas (n = 21) were included. Apart from haematological complications, no WHO grade III-IV complications were observed. One patient died due to cardiac arrest after transplantation.


RESULTS
Following chemotherapy and/or surgery, but prior to high-dose chemotherapy, diagnoses were made of: no evidence of disease (NED; n = 12), partial remission (n = 17), stable disease (n = 3) and progressive disease (PD; n = 6). Six patients died within 8 months due to PD, in 18 patients disease recurred and led to death and 13 patients are alive with/without disease. Median progression-free survival was 19.1 months (range: 0-121) for all patients, and 48.8 months (range: 3-121) for 12 patients with NED.


CONCLUSIONS
A subgroup of patients with NED before high-dose chemotherapy gained survival benefit. Therefore, we emphasize the value of high-dose chemotherapy as a treatment option for younger patients with a good performance status in partial or complete remission.
Kasper
Bernd
B
Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany. mail@berndkasper.de
Dietrich
Sascha
S
Mechtersheimer
Gunhild
G
Ho
Anthony D
AD
Egerer
Gerlinde
G
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002813:Chondrosarcoma / Q000188:drug therapy / Q000601:surgery; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000188:drug therapy / Q000601:surgery; D008080:Liposarcoma / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000188:drug therapy / Q000601:surgery; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000601:surgery; D012509:Sarcoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000601:surgery; D013584:Sarcoma, Synovial / Q000188:drug therapy / Q000601:surgery; D033581:Stem Cell Transplantation