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Hall KS, Bruland ØS, Bjerkehagen B, et al. Preoperative accelerated radiotherapy combined with chemotherapy in a defined cohort of patients with high risk soft tissue sarcoma: a Scandinavian Sarcoma Group study. Clin Sarcoma Res. 2020;10(1):22doi: 10.1186/s13569-020-00145-5.
Hall, K. S., Bruland, �. �. S., Bjerkehagen, B., Lidbrink, E., Jebsen, N., Hagberg, H., Papworth, K., Hagberg, O., Trovik, C., Bauer, H., & Eriksson, M. (2020). Preoperative accelerated radiotherapy combined with chemotherapy in a defined cohort of patients with high risk soft tissue sarcoma: a Scandinavian Sarcoma Group study. Clinical sarcoma research, 10(1), 22. https://doi.org/10.1186/s13569-020-00145-5
Hall, Kirsten Sundby, et al. "Preoperative accelerated radiotherapy combined with chemotherapy in a defined cohort of patients with high risk soft tissue sarcoma: a Scandinavian Sarcoma Group study." Clinical sarcoma research vol. 10,1 (2020): 22. doi: https://doi.org/10.1186/s13569-020-00145-5
Hall KS, Bruland ØS, Bjerkehagen B, Lidbrink E, Jebsen N, Hagberg H, Papworth K, Hagberg O, Trovik C, Bauer H, Eriksson M. Preoperative accelerated radiotherapy combined with chemotherapy in a defined cohort of patients with high risk soft tissue sarcoma: a Scandinavian Sarcoma Group study. Clin Sarcoma Res. 2020 Nov 17;10(1):22. doi: 10.1186/s13569-020-00145-5. PMID: 33292545; PMCID: PMC7672981.
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Clin Sarcoma Res. 2020 Nov 17;10(1):22. doi: 10.1186/s13569-020-00145-5.

Preoperative accelerated radiotherapy combined with chemotherapy in a defined cohort of patients with high risk soft tissue sarcoma: a Scandinavian Sarcoma Group study.

Clinical sarcoma research

Kirsten Sundby Hall, Øyvind S Bruland, Bodil Bjerkehagen, Elisabet Lidbrink, Nina Jebsen, Hans Hagberg, Karin Papworth, Oskar Hagberg, Clement Trovik, Henrik Bauer, Mikael Eriksson

Affiliations

  1. Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway. [email protected].
  2. Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
  3. Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
  4. Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
  5. Institute for Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
  6. Department of Medical Oncology, Karolinska University Hospital, Stockholm, Sweden.
  7. Departments of Oncology and Orthopedics, Haukeland University Hospital and Centre for Cancer Biomarkers (CCBIO), University of Bergen, Bergen, Norway.
  8. Department of Oncology, Uppsala University Hospital, Uppsala, Sweden.
  9. Department of Oncology, Norrlands University Hospital, Umeå, Sweden.
  10. Institution of Translation Medicine, Lund University, Malmö, Sweden.
  11. Department Musculo-Skeletal Tumor Service/Orthopedics, Haukeland University Hospital, Bergen, Norway.
  12. Musculo-Skeletal Tumor Service, Karolinska University Hospital, Stockholm, Sweden.
  13. Department of Oncology, Skåne University Hospital, and Lund University, Lund, Sweden.

PMID: 33292545 PMCID: PMC7672981 DOI: 10.1186/s13569-020-00145-5

Abstract

BACKGROUND: We recently reported outcomes from a Scandinavian Sarcoma Group adjuvant study (SSG XX group A) conducted on localized and operable high risk soft tissue sarcoma (STS) of the extremities and trunk wall. SSG XX, group B, comprised of patients in a defined cohort with locally advanced STS considered at high risk for intralesional surgery. These patients received preoperative accelerated radiotherapy, together with neoadjuvant and adjuvant chemotherapy. Herein we report the results of this group B.

METHODS: Twenty patients with high-grade, locally advanced and deep STS located in lower extremities (n = 12), upper extremities (5) or trunk wall (3) were included. The median age was 59 years and 14 patients were males. The treatment regimen consisted of 6 cycles of doxorubicin (60 mg/m

RESULTS: Median follow-up time for metastasis-free survival (MFS) was 2.8 years (range 0.3-10.4). The 5-year MFS was 49.5% (95% confidence interval [CI] 31.7-77.4). The median follow-up time was 5.4 years (range 0.3-10.4) for overall survival (OS). The 5-year OS was 64.0% (95% CI 45.8-89.4). The median tumour size was 13 cm, with undifferentiated pleomorphic sarcoma (n = 10) and synovial sarcoma (n = 6) diagnosed most frequently. All patients completed surgery. Resection margins were R0 in 19 patients and R1 in 1 patient. No patients had evidence of disease progression preoperatively. Three patients experienced a local recurrence, in 2 after lung metastases had already been diagnosed. Eleven patients (55%) had postoperative wound problems (temporary in 8 and persistent in 3).

CONCLUSIONS: Preoperative chemotherapy and radiotherapy were associated with temporary wound-healing problems. Survival outcomes, local control and toxicities were deemed satisfactory when considering the locally advanced sarcoma disease status at primary diagnosis. Trial registration This study was registered at ClinicalTrials.gov Identifier NCT00790244 and with European Union Drug Regulating Authorities Clinical Trials No. EUDRACT 2007-001152-39.

Keywords: Accelerated; Adjuvant; Chemotherapy; Preoperative; Radiotherapy; Soft tissue sarcoma; Survival; Toxicity

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