Dataset Information

Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study.

ABSTRACT:

Background

An increasing number and proportion of cancer patients with apparently localised disease are treated with chemotherapy and radiation therapy in contemporary oncology practice. In a pilot study of radiation-induced sarcoma (RIS) patients, we demonstrated that chemotherapy was associated with a reduced time to development of RIS. We now present a multi-centre collaborative study to validate this association.

Methods

This was a retrospective cohort study of RIS cases across five large international sarcoma centres between 1 January 2000 to 31 December 2014. The primary endpoint was time to development of RIS.

Results

We identified 419 patients with RIS. Chemotherapy for the first malignancy was associated with a shorter time to RIS development (HR 1.37; 95% CI: 1.08-1.72; P=0.009). In the multi-variable model, older age (HR 2.11; 95% CI 1.83-2.43; P<0.001) and chemotherapy for the first malignancy (HR 1.61; 95% CI 1.26-2.05; P<0·001) were independently associated with a shorter time to RIS. Anthracyclines and alkylating agents significantly contribute to the effect.

Conclusions

This study confirms an association between chemotherapy given for the first malignancy and a shorter time to development of RIS.

SUBMITTER: Zhang AY

PROVIDER: S-EPMC5537501 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Publications

Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study.

Zhang A Y AY Judson I I Benson C C Wunder J S JS Ray-Coquard I I Grimer R J RJ Quek R R Wong E E Miah A B AB Ferguson P C PC Dufresne A A Teh J Y H JYH Stockler M M Tattersall M H N MHN

British journal of cancer 20170627 3

<h4>Background</h4>An increasing number and proportion of cancer patients with apparently localised disease are treated with chemotherapy and radiation therapy in contemporary oncology practice. In a pilot study of radiation-induced sarcoma (RIS) patients, we demonstrated that chemotherapy was associated with a reduced time to development of RIS. We now present a multi-centre collaborative study to validate this association.<h4>Methods</h4>This was a retrospective cohort study of RIS cases acros ...[more]

PMID: 28654633

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Project description:BACKGROUND:Neoadjuvant radiotherapy (RT) and chemotherapy are applied to large, high-grade extremity soft tissue sarcomas to treat metastatic disease earlier and sterilize margins to perform R0 surgery. However, preoperative RT increases wound complication rates (rWC), delaying adjuvant chemotherapy or preventing it from being administered altogether. Hypofractionated neoadjuvant RT can be offered in this situation, concomitant to chemotherapy, allowing patients to receive chemotherapy as a preoperative treatment in less time with an acceptable rWC. OBJECTIVE:The objectives of this protocol are to maintain low rates of morbidity and mortality compared to literature data, improving survival rates and avoiding poor responders from receiving unnecessary adjuvant chemotherapy. METHODS:This noncontrolled, single-arm, phase 2 clinical trial recruited patients aged over 18 years with high-grade soft tissue sarcomas in the girdles or extremities. Three neoadjuvant chemotherapy (ifosfamide and doxorubicin) cycles were administered with 5 days of hypofractionated RT (25 Gy in 5 fractions) in the second cycle of doxorubicin only. Viable cell counts in the surgical specimen were measured, and patients in whom this value was less than 30% continued to receive an additional 3 full chemotherapy cycles as adjuvant treatment. RESULTS:Primary endpoint will be disease-specific survival measured by the evaluation of local and distant recurrence after neoadjuvant treatment. The secondary endpoints will be wound complication and amputation rates and chemotherapy toxicity. We also will record the viable cell rates after the schema and correlate this with survival. CONCLUSIONS:As seems with other solid tumors, hypofractionated RT has comparable efficacy and safety as conventional fractionation. This modality of treatment combined with chemotherapy could increase the pathological response rates and improve the outcomes of select patients. TRIAL REGISTRATION:ClinicalTrials.gov NCT02812654; https://clinicaltrials.gov/ct2/show/NCT02812654 (Archived by WebCite at http://www.webcitation.org/6qC3puBOy).

Dataset Information

Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study.

Background

Methods

Results

Conclusions

Publications

Chemotherapy with radiotherapy influences time-to-development of radiation-induced sarcomas: a multicenter study.

Similar Datasets

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