The clinical application of hyperthermia with increase of tissue temperatures (range 40-44 degrees C) has been integrated in multimodal anti- cancer strategies. The combination of hyperthermia and chemotherapy or radiochemotherapy has been tested within clinical protocols in order to improve local tumor control and relapse-free survival in patients with high- risk sarcomas.
Materials and Methods:
A total of 58 patients with high-risk retroperitoneal or visceral (RP/V) sarcoma were included in this prospective study.
Patients were treated with 4 cycles of VP-16, ifosfamide and adriamycin combined with regional hyperthermia (RHT) followed by surgery, more chemotherapy and radiation therapy.
Tumor size was > 5cm.
Overall response rate was 33%
Pathologic response rate in 26 patients after surgical resection was 42%
25 patients achieved initial complete response
Median survival was 31 months and 5-year overall survival was 32%
Response to neoadjuvant thermochemotherapy was a prognostic factor of overall survival
Patients who responded to neoadjuvant thermochemotherapy appeared to have improved survival.
The importance of RHT for local tumor control will be tested in a phase III trial.
The retroperitoneal/visceral soft tissue sarcomas carry a formidable prognosis. Although widely used, the roles of adjuvant radiation therapy and chemotherapy have not been established.
New therapeutic agents as well as innovative combined-modality approaches are needed to achieve better outcome.
Jan 23, 2012 - The current staging system and postoperative nomograms, which are based on patient and tumor characteristics and predict prognosis after resection of retroperitoneal sarcoma, are no longer significant one year after survival, according to a study published online Jan. 13 in Cancer.