Significant Clinical Benefit of First-Line Palliative Chemotherapy in Advanced Soft-Tissue Sarcoma : Retrospective Analysis and Identification of Prognostic Factors in 488 Patients

• Published in: Cancer 2008-04, Vol.112 (7), p.1585-1591
• Main Authors: KARAVASILIS, Vasilios, SEDDON, Beatrice M, ASHLEY, Susan, AL-MUDERIS, Omar, FISHER, Cyril, JUDSON, Ian
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Biological and medical sciences; Bone Neoplasms - drug therapy; Bone Neoplasms - secondary; Chemotherapy, Adjuvant; Dermatology; Female; Follow-Up Studies; Humans; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Male; Medical sciences; Middle Aged; Neoplasm Staging; Palliative Care; Prognosis; Prospective Studies; Retrospective Studies; Sarcoma - drug therapy; Sarcoma - pathology; Soft Tissue Neoplasms - drug therapy; Soft Tissue Neoplasms - pathology; Survival Rate; Tumors; Tumors of the skin and soft tissue. Premalignant lesions
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.23332

The efficacy of palliative chemotherapy was investigated in a large group of patients with advanced soft-tissue sarcomas (STS) treated on routine palliative protocols. Patients with STS who had first-line chemotherapy for advanced and/or metastatic disease between 1991 and 2005 were identified from the Royal Marsden Hospital's sarcoma database. Patients with Ewing sarcoma, rhabdomyosarcoma, desmoplastic small round cell tumor, and gastrointestinal stromal tumors were excluded from the study. In all, 488 patients (242 male, 246 female) fulfilled the study criteria. The median age was 49 years and the majority (83%) received chemotherapy for metastatic disease. The most common histologic subtypes were leiomyosarcoma (35%) synovial sarcoma (13%), liposarcoma (10%), and malignant fibrous histiocytoma (10%). In all, 61% received single-agent chemotherapy, usually doxorubicin. An objective response was reported in 33% of patients (53% in those with synovial sarcoma); 22% had stable disease and 45% derived 'clinical benefit' (objective responses + stable disease for >or= 6 months). Median duration of response was 9 months and median posttreatment overall survival (OS) was 12 months. In multivariate analysis, age