LymphedemaV1, Pmc, Corpus, bibRecord, 002851

Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy

Identifieur interne : 002851 ( Pmc/Corpus ); précédent : 002850; suivant : 002852

Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy

Auteurs : Dhara M. Macdermed ; Luke L. Miller ; Terrance D. Peabody ; Michael A. Simon ; Hue H. Luu ; Rex C. Haydon ; Anthony G. Montag ; Samir D. Undevia ; Philip P. Connell

Source :

International journal of radiation oncology, biology, physics [ 0360-3016 ] ; 2009.

RBID : PMC:2931332

Abstract

Purpose

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.

Methods and Materials

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.

Results

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%, p=0.02).

Conclusion

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:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931332

DOI: 10.1016/j.ijrobp.2009.03.015
PubMed: 19577863
PubMed Central: 2931332

Links to Exploration step

PMC:2931332

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><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A2"> Pritzker School of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A4"> Department of Pathology, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A5"> Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
</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>
</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><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A2"> Pritzker School of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A3"> Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A4"> Department of Pathology, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A5"> Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago IL 60637</nlm:aff>
</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><nlm:aff id="A1"> Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</nlm:aff>
</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>
<pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
  <pmc-dir>properties manuscript</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">7603616</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4036</journal-id>
<journal-id journal-id-type="nlm-ta">Int J Radiat Oncol Biol Phys</journal-id>
<journal-title>International journal of radiation oncology, biology, physics</journal-title>
<issn pub-type="ppub">0360-3016</issn>
<issn pub-type="epub">1879-355X</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">19577863</article-id>
<article-id pub-id-type="pmc">2931332</article-id>
<article-id pub-id-type="doi">10.1016/j.ijrobp.2009.03.015</article-id>
<article-id pub-id-type="manuscript">NIHMS230212</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>MacDermed</surname>
<given-names>Dhara M.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
<xref rid="FN2" ref-type="author-notes">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miller</surname>
<given-names>Luke L.</given-names>
</name>
<degrees>BS</degrees>
<xref rid="A2" ref-type="aff">2</xref>
<xref rid="FN2" ref-type="author-notes">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Peabody</surname>
<given-names>Terrance D.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Simon</surname>
<given-names>Michael A.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Luu</surname>
<given-names>Hue H.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Haydon</surname>
<given-names>Rex C.</given-names>
</name>
<degrees>MD PhD</degrees>
<xref rid="A3" ref-type="aff">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Montag</surname>
<given-names>Anthony G.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A4" ref-type="aff">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Undevia</surname>
<given-names>Samir D.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A5" ref-type="aff">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Connell</surname>
<given-names>Philip P.</given-names>
</name>
<degrees>MD</degrees>
<xref rid="A1" ref-type="aff">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
 Department of Radiation & Cellular Oncology, University of Chicago, Chicago IL 60637</aff>
<aff id="A2"><label>2</label>
 Pritzker School of Medicine, University of Chicago, Chicago IL 60637</aff>
<aff id="A3"><label>3</label>
 Section of Orthopaedic Surgery and Rehabilitation, Department of Surgery, University of Chicago, Chicago IL 60637</aff>
<aff id="A4"><label>4</label>
 Department of Pathology, University of Chicago, Chicago IL 60637</aff>
<aff id="A5"><label>5</label>
 Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago IL 60637</aff>
<author-notes><corresp id="FN1">Please address correspondence to: Philip P. Connell, MD, Department of Radiation & Cellular Oncology, University of Chicago Hospitals, 5758 S. Maryland Ave. MC 9006, Chicago, IL 60637, Ph: 773 702-6870, Fax: 773 834-7340, <email>pconnell@radonc.uchicago.edu</email>
</corresp>
<fn id="FN2" fn-type="equal"><label>6</label>
<p>These authors contributed equally to this work.</p>
</fn>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>23</day>
<month>8</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="epub"><day>4</day>
<month>7</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><day>15</day>
<month>3</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>15</day>
<month>3</month>
<year>2011</year>
</pub-date>
<volume>76</volume>
<issue>4</issue>
<fpage>1147</fpage>
<lpage>1153</lpage>
<abstract><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>
</abstract>
<kwd-group><kwd>sarcoma</kwd>
<kwd>radiation therapy</kwd>
<kwd>chemotherapy</kwd>
<kwd>surgery</kwd>
<kwd>necrosis</kwd>
</kwd-group>
<contract-num rid="CA1">R21 CA124557-01A1
				||CA</contract-num>
<contract-sponsor id="CA1">National Cancer Institute : NCI</contract-sponsor>
</article-meta>
</front>
</pmc>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002851 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 002851 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    LymphedemaV1
   |flux=    Pmc
   |étape=   Corpus
   |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/Pmc/Corpus/RBID.i   -Sk "pubmed:19577863" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd   \
       | NlmPubMed2Wicri -a LymphedemaV1

This area was generated with Dilib version V0.6.31.
Data generation: Sat Nov 4 17:40:35 2017. Site generation: Tue Feb 13 16:42:16 2024

	Serveur d'exploration sur le lymphœdème
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Serveur d'exploration sur le lymphœdème

Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy

Primary Tumor Necrosis Predicts Distant Control in Locally Advanced Soft Tissue Sarcomas Following Preoperative Concurrent Chemoradiotherapy

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki