Long-term results of a phase 2 study of neoadjuvant chemotherapy and radiotherapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: Radiation Therapy Oncology Group Trial 9514.
Long-term results of a phase 2 study of neoadjuvant chemotherapy and radiotherapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: Radiation Therapy Oncology Group Trial 9514.
复制标题
新辅助化疗和放射疗法的长期研究在高危，高级，软组织肉瘤和身体壁的管理中：放射治疗肿瘤学组试验9514。
DOI：
10.1002/cncr.25350
复制
发表时间：
2010-10-01
期刊：
影响因子：
6.2
通讯作者：
Eisenberg, Burton
中科院分区：
文献类型：
--
作者：
Kraybill, William G.;Harris, Jonathan;Spiro, Ira J.;Ettinger, David S.;DeLaney, Thomas F.;Blum, Ronald H.;Lucas, David R.;Harmon, David C.;Letson, G. Douglas;Eisenberg, Burton
在软组织肉瘤中使用新辅助和辅助化疗是有争议的。这是一篇对接受新辅助化疗、术前放疗（RT）和辅助化疗的高级别、高危软组织肉瘤患者进行长期（≥5年）随访的报告。四肢和体壁直径≥8cm的高级别软组织肉瘤患者接受3个周期的新辅助化疗（mesna、阿霉素、异环磷酰胺、达卡巴嗪）和术前RT（44个灰色分疗程给药），术后3个周期的化疗（mesna、阿霉素、异环磷酰胺、达卡巴嗪）。对66例患者中的64例进行分析。化疗及放疗后手术61例；R0切除58例（截肢5例），R1切除3例。97%的人经历了3级或更高的毒性，包括3例死亡。这些毒性是短期的。存活患者中位随访时间为7.7年，5年局部区域失败（包括截肢）和远处转移率分别为22.2%（95%可信区间[CI]， 11.8-32.6）和28.1% （95% CI, 17.0-39.2）。最常见的转移部位是肺。估计5年无病生存率、远端无病生存率和总生存率分别为56.1% （95% CI, 43.9-68.3）、64.1% （95% CI, 52.3-75.8）和71.2% （95% CI, 60.0-82.5）。虽然毒性很明显，但它在病程中是有限的，大部分在1年内消退。在这种高风险肿瘤中，长期结果比预期的要好。
The use of neoadjuvant and adjuvant chemotherapy in soft tissue sarcomas is controversial. This is a report of long-term (≥5 years) follow-up in patients with high-grade, high-risk soft tissue sarcomas treated with neoadjuvant chemotherapy, preoperative radiotherapy (RT), and adjuvant chemotherapy. Patients with high-grade soft tissue sarcoma ≥8 cm in diameter of the extremities and body wall received 3 cycles of neoadjuvant chemotherapy (mesna, doxorubicin, ifosfamide, and dacarbazine) and preoperative RT (44 grays administered in split courses), and 3 cycles of postoperative chemotherapy (mesna, doxorubicin, ifosfamide, and dacarbazine). Sixty-four of 66 patients were analyzed. After chemotherapy and RT, 61 patients had surgery; 58 had R0 resections (5 amputations), and 3 had R1 resections. Ninety-seven percent experienced grade 3 or higher toxicity, including 3 deaths. These toxicities were short term. With a median follow-up of 7.7 years in surviving patients, the 5-year rates of locoregional failure (including amputation), and distant metastasis were 22.2% (95% confidence interval [CI], 11.8–32.6) and 28.1% (95% CI, 17.0–39.2). The most common site of metastasis was lung. Estimated 5-year rates of disease-free survival, distant disease-free survival, and overall survival were 56.1% (95% CI, 43.9–68.3), 64.1% (95% CI, 52.3–75.8), and 71.2% (95% CI, 60.0–82.5), respectively. Although the toxicity was significant, it was limited in its course and for the most part resolved by 1 year. The long-term outcome was better than might be expected in such high-risk tumors.
登录
查看更多内容
影响因子：
11.5
作者：
Lopez, Gonzalo;Liu, Juehui;Lev, Dina C.
通讯作者：
Lev, Dina C.
影响因子：
9
作者：
Eilber, Fritz C.;Brennan, Murray F.;Singer, Samuel
通讯作者：
Singer, Samuel
影响因子：
9
作者：
LAWRENCE, W;DONEGAN, WL;WINCHESTER, D
通讯作者：
WINCHESTER, D
影响因子：
45.3
作者：
Kraybill, WG;Harris, J;Eiaberg, B
通讯作者：
Eiaberg, B
影响因子：
45.3
作者：
Coindre, JM;Terrier, P;Contesso, G
通讯作者：
Contesso, G