Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy
Identifieur interne : 006090 ( Main/Exploration ); précédent : 006089; suivant : 006091Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy
Auteurs : Dhara M. Macdermed [États-Unis] ; Luke L. Miller [États-Unis] ; Terrance D. Peabody [États-Unis] ; Michael A. Simon [États-Unis] ; Hue H. Luu [États-Unis] ; Rex C. Haydon [États-Unis] ; Anthony G. Montag [États-Unis] ; Samir D. Undevia [États-Unis] ; Philip P. Connell [États-Unis]Source :
- International journal of radiation oncology, biology, physics [ 0360-3016 ] ; 2009.
Abstract
Various neoadjuvant approaches have been evaluated for the treatment of locally advanced soft tissue sarcomas. This retrospective study describes a uniquely modified version of the Eilber regimen developed at University of Chicago.
Thirty-four patients (28 stage III and 6 stage IV) patients with locally advanced soft tissue sarcomas of an extremity were treated between 1995 and 2008. All patients received preoperative therapy including ifosfamide (2.5 g/m2/day × 5 days) with concurrent radiation (28 Gy in 3.5 Gy daily fractions), sandwiched between various chemotherapy regimens. Postoperatively, 47% received further adjuvant chemotherapy.
Most tumors (94%) were grade 3 and all were T2b, with a median size of 10.3 cm. Wide excision was performed in 29 patients (85%), and 5 required amputation. Of the resected tumor specimens, 50% exhibited high (≥90%) treatment-induced necrosis and 11.8% had a complete pathologic response. Surgical margins were negative in all patients. The 5-year survival was 42.3% for all patients and 45.2% for stage III patients. For limb-preservation patients, the 5-year local control was 89.0% and reoperation was required for wound complications in 17.2%. The 5-year freedom from distant metastasis (FFDM) was 53.4% (stage IV patients excluded), and FFDM was superior if treatment-induced tumor necrosis was ≥90% (84.6% vs. 19.9%,
This well-tolerated concurrent chemoradiotherapy approach yields excellent rates of limb preservation and local control. The resulting treatment-induced necrosis rates are predictive of subsequent metastatic risk, and this information may provide an opportunity to guide postoperative systemic therapies.
Url:
DOI: 10.1016/j.ijrobp.2009.03.015
PubMed: 19577863
PubMed Central: 2931332
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 002851
- to stream Pmc, to step Curation: 002850
- to stream Pmc, to step Checkpoint: 003622
- to stream Ncbi, to step Merge: 003495
- to stream Ncbi, to step Curation: 003495
- to stream Ncbi, to step Checkpoint: 003495
- to stream Main, to step Merge: 006162
- to stream Main, to step Curation: 006090
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy</title>
<author><name sortKey="Macdermed, Dhara M" sort="Macdermed, Dhara M" uniqKey="Macdermed D" first="Dhara M." last="Macdermed">Dhara M. Macdermed</name>
<affiliation wicri:level="2"><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Department of Radiation & Cellular Oncology, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Miller, Luke L" sort="Miller, Luke L" uniqKey="Miller L" first="Luke L." last="Miller">Luke L. Miller</name>
<affiliation wicri:level="2"><nlm:aff id="A2"> Pritzker School of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Pritzker School of Medicine, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Peabody, Terrance D" sort="Peabody, Terrance D" uniqKey="Peabody T" first="Terrance D." last="Peabody">Terrance D. Peabody</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Simon, Michael A" sort="Simon, Michael A" uniqKey="Simon M" first="Michael A." last="Simon">Michael A. Simon</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Luu, Hue H" sort="Luu, Hue H" uniqKey="Luu H" first="Hue H." last="Luu">Hue H. Luu</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Haydon, Rex C" sort="Haydon, Rex C" uniqKey="Haydon R" first="Rex C." last="Haydon">Rex C. Haydon</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Montag, Anthony G" sort="Montag, Anthony G" uniqKey="Montag A" first="Anthony G." last="Montag">Anthony G. Montag</name>
<affiliation wicri:level="2"><nlm:aff id="A4"> Department of Pathology, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Department of Pathology, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Undevia, Samir D" sort="Undevia, Samir D" uniqKey="Undevia S" first="Samir D." last="Undevia">Samir D. Undevia</name>
<affiliation wicri:level="2"><nlm:aff id="A5"> Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Hematology/Oncology, Department of Medicine, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Connell, Philip P" sort="Connell, Philip P" uniqKey="Connell P" first="Philip P." last="Connell">Philip P. Connell</name>
<affiliation wicri:level="2"><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Department of Radiation & Cellular Oncology, University of Chicago</wicri:cityArea>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">19577863</idno>
<idno type="pmc">2931332</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931332</idno>
<idno type="RBID">PMC:2931332</idno>
<idno type="doi">10.1016/j.ijrobp.2009.03.015</idno>
<date when="2009">2009</date>
<idno type="wicri:Area/Pmc/Corpus">002851</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002851</idno>
<idno type="wicri:Area/Pmc/Curation">002850</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002850</idno>
<idno type="wicri:Area/Pmc/Checkpoint">003622</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003622</idno>
<idno type="wicri:Area/Ncbi/Merge">003495</idno>
<idno type="wicri:Area/Ncbi/Curation">003495</idno>
<idno type="wicri:Area/Ncbi/Checkpoint">003495</idno>
<idno type="wicri:doubleKey">0360-3016:2009:Macdermed D:primary:tumor:necrosis</idno>
<idno type="wicri:Area/Main/Merge">006162</idno>
<idno type="wicri:Area/Main/Curation">006090</idno>
<idno type="wicri:Area/Main/Exploration">006090</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy</title>
<author><name sortKey="Macdermed, Dhara M" sort="Macdermed, Dhara M" uniqKey="Macdermed D" first="Dhara M." last="Macdermed">Dhara M. Macdermed</name>
<affiliation wicri:level="2"><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Department of Radiation & Cellular Oncology, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Miller, Luke L" sort="Miller, Luke L" uniqKey="Miller L" first="Luke L." last="Miller">Luke L. Miller</name>
<affiliation wicri:level="2"><nlm:aff id="A2"> Pritzker School of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Pritzker School of Medicine, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Peabody, Terrance D" sort="Peabody, Terrance D" uniqKey="Peabody T" first="Terrance D." last="Peabody">Terrance D. Peabody</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Simon, Michael A" sort="Simon, Michael A" uniqKey="Simon M" first="Michael A." last="Simon">Michael A. Simon</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Luu, Hue H" sort="Luu, Hue H" uniqKey="Luu H" first="Hue H." last="Luu">Hue H. Luu</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Haydon, Rex C" sort="Haydon, Rex C" uniqKey="Haydon R" first="Rex C." last="Haydon">Rex C. Haydon</name>
<affiliation wicri:level="2"><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Montag, Anthony G" sort="Montag, Anthony G" uniqKey="Montag A" first="Anthony G." last="Montag">Anthony G. Montag</name>
<affiliation wicri:level="2"><nlm:aff id="A4"> Department of Pathology, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Department of Pathology, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Undevia, Samir D" sort="Undevia, Samir D" uniqKey="Undevia S" first="Samir D." last="Undevia">Samir D. Undevia</name>
<affiliation wicri:level="2"><nlm:aff id="A5"> Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Section of Hematology/Oncology, Department of Medicine, University of Chicago</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Connell, Philip P" sort="Connell, Philip P" uniqKey="Connell P" first="Philip P." last="Connell">Philip P. Connell</name>
<affiliation wicri:level="2"><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Illinois</region>
</placeName>
<wicri:cityArea> Department of Radiation & Cellular Oncology, University of Chicago</wicri:cityArea>
</affiliation>
</author>
</analytic>
<series><title level="j">International journal of radiation oncology, biology, physics</title>
<idno type="ISSN">0360-3016</idno>
<idno type="eISSN">1879-355X</idno>
<imprint><date when="2009">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P2">Various neoadjuvant approaches have been evaluated for the treatment of locally advanced soft tissue sarcomas. This retrospective study describes a uniquely modified version of the Eilber regimen developed at University of Chicago.</p>
</sec>
<sec sec-type="materials|methods" id="S2"><title>Methods and Materials</title>
<p id="P3">Thirty-four patients (28 stage III and 6 stage IV) patients with locally advanced soft tissue sarcomas of an extremity were treated between 1995 and 2008. All patients received preoperative therapy including ifosfamide (2.5 g/m<sup>2</sup>
/day × 5 days) with concurrent radiation (28 Gy in 3.5 Gy daily fractions), sandwiched between various chemotherapy regimens. Postoperatively, 47% received further adjuvant chemotherapy.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P4">Most tumors (94%) were grade 3 and all were T2b, with a median size of 10.3 cm. Wide excision was performed in 29 patients (85%), and 5 required amputation. Of the resected tumor specimens, 50% exhibited high (≥90%) treatment-induced necrosis and 11.8% had a complete pathologic response. Surgical margins were negative in all patients. The 5-year survival was 42.3% for all patients and 45.2% for stage III patients. For limb-preservation patients, the 5-year local control was 89.0% and reoperation was required for wound complications in 17.2%. The 5-year freedom from distant metastasis (FFDM) was 53.4% (stage IV patients excluded), and FFDM was superior if treatment-induced tumor necrosis was ≥90% (84.6% vs. 19.9%, <italic>p</italic>
=0.02).</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P5">This well-tolerated concurrent chemoradiotherapy approach yields excellent rates of limb preservation and local control. The resulting treatment-induced necrosis rates are predictive of subsequent metastatic risk, and this information may provide an opportunity to guide postoperative systemic therapies.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Illinois</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Illinois"><name sortKey="Macdermed, Dhara M" sort="Macdermed, Dhara M" uniqKey="Macdermed D" first="Dhara M." last="Macdermed">Dhara M. Macdermed</name>
</region>
<name sortKey="Connell, Philip P" sort="Connell, Philip P" uniqKey="Connell P" first="Philip P." last="Connell">Philip P. Connell</name>
<name sortKey="Haydon, Rex C" sort="Haydon, Rex C" uniqKey="Haydon R" first="Rex C." last="Haydon">Rex C. Haydon</name>
<name sortKey="Luu, Hue H" sort="Luu, Hue H" uniqKey="Luu H" first="Hue H." last="Luu">Hue H. Luu</name>
<name sortKey="Miller, Luke L" sort="Miller, Luke L" uniqKey="Miller L" first="Luke L." last="Miller">Luke L. Miller</name>
<name sortKey="Montag, Anthony G" sort="Montag, Anthony G" uniqKey="Montag A" first="Anthony G." last="Montag">Anthony G. Montag</name>
<name sortKey="Peabody, Terrance D" sort="Peabody, Terrance D" uniqKey="Peabody T" first="Terrance D." last="Peabody">Terrance D. Peabody</name>
<name sortKey="Simon, Michael A" sort="Simon, Michael A" uniqKey="Simon M" first="Michael A." last="Simon">Michael A. Simon</name>
<name sortKey="Undevia, Samir D" sort="Undevia, Samir D" uniqKey="Undevia S" first="Samir D." last="Undevia">Samir D. Undevia</name>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 006090 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 006090 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Sante |area= LymphedemaV1 |flux= Main |étape= Exploration |type= RBID |clé= PMC:2931332 |texte= Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:19577863" \ | HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \ | NlmPubMed2Wicri -a LymphedemaV1
This area was generated with Dilib version V0.6.31. |