Neoadjuvant concurrent chemoradiotherapy with and without hyperthermia in retroperitoneal sarcomas: feasibility, efficacy, toxicity, and long-term outcome

Willner A, Fechner K, Agaimy A, Haller F, Eckstein M, Ott O, Putz F, Gaipl U, Kersting S, Meidenbauer N, Grützmann R, Fietkau R, Semrau S (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Strahlentherapie und Onkologie Urban & Vogel

DOI: 10.1007/s00066-021-01830-0

Abstract

Purpose Retroperitoneal (RPS) sarcomas are associated with poor local and abdominal tumor control. However, the benefit of preoperative radio- or chemotherapy alone for these entities is currently unclear. Moreover, as intermediate- and high-grade sarcomas have a tendency toward early metastasis, exploration of neoadjuvant strategies is of high importance. This analysis reports the results of our 20-year single-institution experience with preoperative neoadjuvant concurrent chemoradiation. Methods From 2000-2019, 27 patients with intermediate- or high-grade RPS (12 dedifferentiated liposarcoma, 10 leiomyosarcoma, 5 others) were treated with radiotherapy (median dose: 50.4 Gy; range 45-75 Gy) and two cycles of chemotherapy (doxorubicin 50 mg/m(2) BSA/d3 q28 and ifosfamide 1.5 g/m(2) BSA/d1-5 q28) in neoadjuvant intent. Chemotherapy consisted of doxorubicin alone in two cases and ifosfamide alone in one case. Fifteen patients (56%) additionally received deep regional hyperthermia. Results The median follow-up time was 53 months (+/- 56.7 months). 92% of patients received two cycles of chemotherapy as planned and 92% underwent surgery. At 5 and 10 years, abdominal-recurrence-free survival was 74.6% (+/- 10.1%) and 66.3% (+/- 11.9%), distant metastasis-free survival was 67.2% (+/- 9.7%) and 59.7% (+/- 11.1%), and overall survival was 60.3% (+/- 10.5%) and 60.3% (+/- 10.5%), respectively. CTC grade III and IV toxicities were leukocytopenia (85%), thrombocytopenia (33%), and anemia (11%). There were no treatment-related deaths. Conclusion Neoadjuvant chemoradiotherapy with and without hyperthermia for retroperitoneal sarcomas is feasible and provided high local control of intermediate- and high-grade sarcoma.

Authors with CRIS profile

Katja Fechner Department of Surgery Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Florian Haller Professur für Diagnostische Molekularpathologie Markus Eckstein Institute of Pathology Oliver Ott Medizinische Fakultät Florian Putz Department of Radiation Oncology Udo Gaipl Department of Radiation Oncology Norbert Meidenbauer Department of Medicine 5 – Haematology and Oncology Robert Grützmann Department of Surgery Rainer Fietkau Lehrstuhl für Strahlentherapie Sabine Semrau Medizinische Fakultät

How to cite

APA:

Willner, A., Fechner, K., Agaimy, A., Haller, F., Eckstein, M., Ott, O.,... Semrau, S. (2021). Neoadjuvant concurrent chemoradiotherapy with and without hyperthermia in retroperitoneal sarcomas: feasibility, efficacy, toxicity, and long-term outcome. Strahlentherapie und Onkologie. https://doi.org/10.1007/s00066-021-01830-0

MLA:

Willner, Alexander, et al. "Neoadjuvant concurrent chemoradiotherapy with and without hyperthermia in retroperitoneal sarcomas: feasibility, efficacy, toxicity, and long-term outcome." Strahlentherapie und Onkologie (2021).

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