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Neoadjuvant treatment of soft tissue sarcoma

  • Radiotherapy
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate disease-free survival (DFS), overall survival and toxicity of patients who underwent preoperative therapy for soft tissue sarcoma.

Materials and methods

The data of 38 consecutive patients affected by soft tissue sarcoma were retrospectively analysed. Six (15.8 %) patients were treated only with neoadjuvant radiotherapy, and 32 (84.2 %) with neoadjuvant chemo-radiation therapy. Surgery was performed within 4–6 weeks after the completion of neoadjuvant treatment.

Results

Median follow-up was 4.9 years (range 1–13.7 years). All patients received preoperative external beam radiotherapy (RT). Most patients (84.2 %) underwent neoadjuvant chemotherapy treatment associated with radiotherapy. After neoadjuvant treatment, the majority of patients underwent wide excision (32 out of 38) and five patients had marginal surgery; only one patient underwent amputation. Local recurrence was observed in only two patients (5.2 %). Fourteen (36.8 %) patients experienced metastatic relapse. At the time of our analysis 13 patients (34.2 %) had died due to metastatic spread of the disease. In our series, DFS in relation to distant metastases (DM) showed a significant result for lower limb involvement (p = 0.038) and marginal excision (p = 0.024), both predictors of a worse DFS, histology was statistically significant although it was not possible to evaluate the risk for specific histology due to the small number of events in the different subtypes.

Conclusions

The results obtained from our study are encouraging with regard to the feasibility and efficacy of preoperative RT in the treatment of soft tissue sarcoma in view of the results obtained in terms of local control, limb sparing and safety.

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Conflict of interest

Daniela Greto, Lorenzo Livi, Calogero Saieva, Pierluigi Bonomo, Icro Meattini, Mauro Loi, Lucia Di Brina, Giovanni Beltrami, Domenico Campanacci, Guido Scoccianti, Rodolfo Capanna, Monica Mangoni, Fabiola Paiar, Alessandro Franchi, Giampaolo Biti declare no conflict of interest.

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Authors and Affiliations

  1. Radiotherapy Unit, University of Florence, Largo Brambilla 1, 50134, Florence, Italy

    Daniela Greto, Lorenzo Livi, Icro Meattini, Mauro Loi, Lucia Di Brina, Monica Mangoni, Fabiola Paiar & Giampaolo Biti

  2. Department of Pathology, University of Florence, Florence, Italy

    Alessandro Franchi

  3. Radiotherapy Unit, IFCA, University of Florence, Florence, Italy

    Pierluigi Bonomo

  4. Department of Oncologic–Orthopaedic Surgery, AOU Careggi, Florence, Italy

    Giovanni Beltrami, Domenico Campanacci, Guido Scoccianti & Rodolfo Capanna

  5. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Center, Scientific Institute of Tuscany, Florence, Italy

    Calogero Saieva

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  1. Daniela Greto
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  2. Lorenzo Livi
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  3. Calogero Saieva
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Correspondence to Daniela Greto.

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Greto, D., Livi, L., Saieva, C. et al. Neoadjuvant treatment of soft tissue sarcoma. Radiol med 119, 195–200 (2014). https://doi.org/10.1007/s11547-013-0331-6

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  • DOI: https://doi.org/10.1007/s11547-013-0331-6

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