Evaluation of two modalities of perioperative treatment in the management of extremity and truncal soft tissue sarcomas: neoadjuvant concurrent chemoradiotherapy and sequential treatment

Purpose Patients with locally advanced grade 2–3 extremity/truncal soft tissue sarcomas (STS) are at high risk of recurrence. The objective of this study was to assess the efficacy and feasibility of neoadjuvant concurrent chemoradiotherapy (cCRT) in selected grade 2–3 patients with limb or trunk wa...

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Published in:Strahlentherapie und Onkologie 2021-12, Vol.197 (12), p.1051-1062
Main Authors: Attal, J., Cabarrou, B., Valentin, T., Nesseler, J. P., Stoeckle, E., Ducassou, A., Filleron, T., Le Guellec, S., Boulet, B., Vogin, G., Ferron, G., Moyal, E. Cohen-Jonathan, Delannes, M., Chevreau, C.
Format: Article
Language:English
Subjects:
Antineoplastic Combined Chemotherapy Protocols
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Cancer
Chemoradiotherapy
Chemoradiotherapy - methods
Chemotherapy
Disease-Free Survival
Extremities
Extremities - pathology
Feasibility
Humans
Life Sciences
Medicine
Medicine & Public Health
Neoadjuvant Therapy
Neoadjuvant Therapy - methods
Neoplasm Staging
Oncology
Original Article
Radiation therapy
Radiotherapy
Retrospective Studies
Sarcoma
Sarcoma - pathology
Sarcoma - therapy
Soft tissues
Survival
Treatment Outcome
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Summary:Purpose Patients with locally advanced grade 2–3 extremity/truncal soft tissue sarcomas (STS) are at high risk of recurrence. The objective of this study was to assess the efficacy and feasibility of neoadjuvant concurrent chemoradiotherapy (cCRT) in selected grade 2–3 patients with limb or trunk wall STS, and to compare this schedule to a sequential approach combining neoadjuvant chemotherapy and adjuvant radiotherapy. Methods We retrospectively included patients who underwent neoadjuvant cCRT at two comprehensive cancer centers from 1992–2016. We then compared these results to those of patients treated with preoperative chemotherapy and postoperative radiotherapy from a third comprehensive cancer center with a propensity score matched analysis. Results A total of 53 patients were treated by neoadjuvant cCRT; 58 patients could be matched with 29 patients in each treatment group after propensity score matching. Disease-free survival and overall survival at 5 years were 54.9 and 63.5%, respectively with neoadjuvant cCRT, with no significant difference when compared to the sequential treatment group. R0 resection rate was higher (90.9 vs 44.8%, p  
ISSN:0179-7158
1439-099X
DOI:10.1007/s00066-021-01847-5