title: [Systemic therapy and hyperthermia for locally advanced soft tissue sarcoma].
abstract: Patients with high-risk soft tissue sarcomas (FNCLCC grades 2-3, > 5 cm and deep lying) are at a high risk of local recurrence or distant metastases despite optimal surgical tumor resection. Therefore, multimodal treatment should be considered for this difficult to treat patient group. Besides surgery, radiation therapy and chemotherapy, hyperthermia has become a valid, complementary treatment option within multimodal treatment concepts. Hyperthermia in this context means the selective heating of the tumor region to temperatures of 40-43 °C for 60 min by microwave radiation in addition to simultaneous chemotherapy or radiation therapy. A randomized phase III study demonstrated that the addition of hyperthermia to neoadjuvant chemotherapy improved tumor response and was associated with a minimal risk of early disease progression as compared to chemotherapy alone. The addition of hyperthermia to a multimodal treatment regimen for high-risk soft tissue sarcoma consisting of surgery, radiation therapy and chemotherapy, either in the neoadjuvant or adjuvant setting after incomplete or marginal tumor resection, significantly improved local progression-free and disease-free survival. Based on these results and due to the generally good tolerability of hyperthermia, this treatment method in combination with chemotherapy should be considered as a standard treatment option within multimodal treatment approaches for locally advanced high-risk soft tissue sarcoma.
authors.affiliation: Medizinische Klinik III, Klinikum der Universität München - Campus Grosshadern, Marchioninistr. 15, 81377, München, Deutschland, lars.lindner@med.uni-muenchen.de.
authors.forename: L H
authors.initials: LH
authors.lastname: Lindner
authors.forename: M
authors.initials: M
authors.lastname: Angele
authors.forename: H R
authors.initials: HR
authors.lastname: Dürr
authors.forename: J
authors.initials: J
authors.lastname: Rauch
authors.forename: C
authors.initials: C
authors.lastname: Bruns
mesh_terms: D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D006979:Hyperthermia, Induced; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012509:Sarcoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*
references.citation: Lancet Oncol. 2012 Oct;13(10):1045-54
references.pmid: 22954508
references.citation: Ann Surg. 1998 Sep;228(3):355-65
references.pmid: 9742918
references.citation: Eur J Cancer. 2001 Jun;37(9):1096-103
references.pmid: 11378339
references.citation: J Clin Oncol. 1997 Dec;15(12):3481-7
references.pmid: 9396401
references.citation: Cancer. 2002 Sep 1;95(5):1120-6
references.pmid: 12209699
references.citation: Ann Oncol. 2010 Dec;21(12):2436-2441
references.pmid: 20439343
references.citation: J Clin Oncol. 2006 Feb 1;24(4):619-25
references.pmid: 16446334
references.citation: Tumori. 2006 Mar-Apr;92(2):92-7
references.pmid: 16724686
references.citation: Lancet. 1997 Dec 6;350(9092):1647-54
references.pmid: 9400508
references.citation: Lancet Oncol. 2010 Jun;11(6):561-70
references.pmid: 20434400
references.citation: Cancer. 2008 Aug 1;113(3):573-81
references.pmid: 18521899
references.citation: Lancet Oncol. 2002 Aug;3(8):487-97
references.pmid: 12147435
references.citation: Eur J Cancer. 2008 Nov;44(17):2546-54
references.pmid: 18789678
references.citation: J Clin Oncol. 2012 Mar 10;30(8):850-6
references.pmid: 22312103
references.citation: J Clin Oncol. 2001 Mar 1;19(5):1238-47
references.pmid: 11230464