ASO Author Reflections: Chemoradiation for High-Risk Soft Tissue Sarcomas

Excerpt

The mainstay of treatment for large, high-grade soft tissue sarcomas of the extremity consists of wide excision and radiation therapy, an approach that results in excellent rates of local control but does not prevent the development of fatal, metastatic disease in up to 50% of patients. The use of adjuvant or neoadjuvant chemotherapy to mitigate this risk remains controversial with conflicting study results and a lack of consensus. Not surprisingly, there is wide variation amongst sarcoma centers in the use and timing of chemotherapy. In 2008, we published the results of a phase II study using an intensified chemotherapy regimen consisting of epirubicin and ifosfamide combined with preoperative hypofractionated radiation in patients with high-risk soft tissue sarcomas of the extremities or body wall.1 In this follow-up, we report long-term outcomes from this study supplemented with data from patients treated off-study at our institution, providing an extensive experience of how this trimodality approach may impact outcomes in high-risk disease.2 …