title: Neoadjuvant chemoradiation therapy for soft tissue sarcomas of the extremities.
abstract: OBJECTIVE
  Neoadjuvant and adjuvant therapies for soft tissue sarcomas of the extremities are still controversial. The aim of this study was to analyze the results of a protocol of neoadjuvant chemoradiation therapy for extremity sarcomas.
  
  
  METHODS
  A retrospective analysis was carried out in a consecutive series of 49 adult patients with advanced extremity soft tissue sarcomas that could not be resected with adequate margins during the primary resection. All patients were treated with a protocol of preoperative radiation therapy at a total dose of 30 Gy, concomitant with doxorubicin (60 mg/m(2)) chemotherapy. The main endpoints assessed were local recurrence-free survival, metastasis-free survival and overall survival. The median follow-up time was 32.1 months.
  
  
  RESULTS
  The five-year local recurrence-free survival, metastasis-free survival and overall survival rates were 81.5%, 46.7% and 58.3%, respectively. For high-grade tumors, the five-year metastasis-free and overall survival rates were only 36.3% and 41.2%, respectively. Severe wound complications were observed in 41.8% of the patients who underwent surgery. These complications precluded adjuvant chemotherapy in 73.7% (14/19) of the patients eligible to receive it.
  
  
  CONCLUSIONS
  In this study, neoadjuvant chemoradiation therapy was associated with a good local control rate, but the distant relapse-free rate and overall survival rate were still poor. The high rate of wound complications modified the planning of adjuvant treatment in most patients.
authors: Departamento de Cirurgia Pélvica, Hospital do Câncer A.C. Camargo, Fundação Antônio Prudente - São Paulo/SP, Brasil. samuel.aguiar.jr@uol.com.br
authors: Samuel
authors: S
authors: Aguiar Junior
authors: Fábio de Oliveira
authors: Fde O
authors: Ferreira
authors: Benedito Mauro
authors: BM
authors: Rossi
authors: Erika Maria Monteiro
authors: EM
authors: Santos
authors: João Victor
authors: JV
authors: Salvajoli
authors: Ademar
authors: A
authors: Lopes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D004317:Doxorubicin / Q000009:adverse effects; D004812:Epidemiologic Methods; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012509:Sarcoma / Q000401:mortality* / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000401:mortality* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004317:Doxorubicin