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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2015

01-09-2015 | Bone and Soft Tissue Sarcomas

Combined Radiation Therapy and Sunitinib for Preoperative Treatment of Soft Tissue Sarcoma

Authors: Jens Jakob, MD, Anna Simeonova, MD, Bernd Kasper, MD, PhD, Ulrich Ronellenfitsch, MD, Frederik Wenz, MD, PhD, Peter Hohenberger, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2015

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Abstract

Background

Antiangiogenic substances and radiation therapy (RT) may have synergistic effects and improve irradiation efficacy. We present a cohort study evaluating the toxicity of combined sunitinib and RT as neoadjuvant treatment of extremity and retroperitoneal soft tissue sarcoma (STS).

Methods

Sixteen patients with locally advanced extremity (6/16) or retroperitoneal (10/16) STS were treated with continuous-dosing sunitinib (15/16: 37.5 mg daily; 1/16: 25 mg daily) and standard RT (45–50.4 Gy) preoperatively. Surgery was scheduled 5–9 weeks following neoadjuvant treatment. The primary goal of the study was to determine combined treatment toxicity according to the Common Terminology Criteria for Adverse Events. Secondary goals were the evaluation of postoperative morbidity and treatment response.

Results

Eight of 16 patients developed grade 3, and one patient developed grade 4, hematological toxicity. One patient experienced grade 3 hand–foot syndrome. The most frequent treatment toxicities of any grade were hematological (15/16) or dermatological (9/16). Three patients had partial response, 11 had stable disease, and 2 had progressive disease according to Response Evaluation Criteria in Solid Tumors (RECIST). Fourteen of 16 patients underwent surgery; tumors were not removed in two patients because of patient refusal or intercurrent metastatic disease. The proportion of tumor necrosis exceeded 90 % in 5 of 14 patients, and 4 patients had postoperative complications requiring reintervention.

Conclusions

Preoperative treatment with concurrent sunitinib and RT was tolerable, and postoperative morbidity did not increase. Combined treatment with RT and sunitinib was also feasible in patients with retroperitoneal STS, and warrants further investigation.
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Metadata
Title
Combined Radiation Therapy and Sunitinib for Preoperative Treatment of Soft Tissue Sarcoma
Authors
Jens Jakob, MD
Anna Simeonova, MD
Bernd Kasper, MD, PhD
Ulrich Ronellenfitsch, MD
Frederik Wenz, MD, PhD
Peter Hohenberger, MD, PhD
Publication date
01-09-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 9/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4680-3

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