title: Adjuvant chemotherapy for soft tissue sarcomas: a 10-year mono-institutional experience.
abstract: OBJECTIVE
  The role of adjuvant chemotherapy (ACT) for soft tissue sarcomas (STS) is not standard practice. We investigated effectiveness and tolerability of ACT in patients (pts) with operated high-risk STS in clinical practice.
  
  
  METHODS
  Medical records of pts with localized STS referred to Istituto Oncologico Veneto, Padova, from January 1, 2003 to July 07, 2012 were reviewed. Data were collected for pts with high-risk STS (size ≥5 cm, high grade and stage III). For those who received ACT, regimens used, drug doses, number of cycles, toxicity, and reasons for dose reduction or treatment interruption were recorded. Disease-free survival (DFS) and overall survival (OS) were calculated with the Kaplan-Meier method.
  
  
  RESULTS
  Out of 96 eligible pts, median age 62 years, 36 received ACT after loco-regional treatment. Median DFS was 29.6 months (95 % CI 13.2-46.0) in pts receiving ACT and 7.8 months (95 % CI 3.9-11.7) in untreated pts (p < 0.0001); median OS was 67.0 months (95 % CI 25.4-108.6) in treated and 33.7 months (95 % CI 23.3-44.2) in untreated pts (p = 0.005). Among pts receiving ACT, a significant difference in DFS was observed between pts with limb/girdle disease (median DFS 82.4 months; 95 % CI 0.0-184.7) and pts with other primary sites (median DFS 18.3 months; 95 % CI 8.0-28.5) (p = 0.052). Grade ≥3 toxicities occurred in 20 pts (20.8 %), leading to dose reductions, delays, and treatment discontinuation in five cases. There was no treatment-related death.
  
  
  CONCLUSIONS
  Our data confirm benefit of ACT with regard to DFS and OS in pts with high-risk STS, greatest for limb/girdle STS.
authors.affiliation: Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128, Padua, Italy. antonella.brunello@ioveneto.it.
authors.forename: Antonella
authors.identifier: http://orcid.org/0000-0003-2583-5226
authors.initials: A
authors.lastname: Brunello
authors.affiliation: Radiation Therapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
authors.forename: Mario Domenico
authors.initials: MD
authors.lastname: Rizzato
authors.affiliation: Melanoma and Sarcoma Unit, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rastrelli
authors.affiliation: Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128, Padua, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Roma
authors.affiliation: Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128, Padua, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Maruzzo
authors.affiliation: Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128, Padua, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Basso
authors.affiliation: Clinical Trials and Biostatics Unit, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fiduccia
authors.affiliation: Radiation Therapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
authors.forename: Maria Samaritana
authors.initials: MS
authors.lastname: Buzzaccarini
authors.affiliation: Radiation Therapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scarzello
authors.affiliation: Melanoma and Sarcoma Unit, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
authors.forename: Carlo Riccardo
authors.initials: CR
authors.lastname: Rossi
authors.affiliation: Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128, Padua, Italy.
authors.forename: Vittorina
authors.initials: V
authors.lastname: Zagonel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy* / Q000453:epidemiology; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D015251:Epirubicin; D007069:Ifosfamide
keywords: Adjuvant; Chemotherapy; Epirubicin; High risk; Ifosfamide; Sarcoma