Brunello Antonella, Rizzato Mario Domenico, Rastrelli Marco, Roma Anna, Maruzzo Marco, Basso Umberto, Fiduccia Pasquale, Buzzaccarini Maria Samaritana, Scarzello Giovanni, Rossi Carlo Riccardo, Zagonel Vittorina
Medical Oncology 1 Unit, Istituto Oncologico Veneto IOV - IRCCS, Via Gattamelata 64, 35128, Padua, Italy.
Radiation Therapy Unit, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy.
J Cancer Res Clin Oncol. 2016 Mar;142(3):679-85. doi: 10.1007/s00432-015-2065-4. Epub 2015 Nov 7.
The role of adjuvant chemotherapy (ACT) for soft tissue sarcomas (STS) is not standard practice. We investigated effectiveness and tolerability of ACT in patients (pts) with operated high-risk STS in clinical practice.
Medical records of pts with localized STS referred to Istituto Oncologico Veneto, Padova, from January 1, 2003 to July 07, 2012 were reviewed. Data were collected for pts with high-risk STS (size ≥5 cm, high grade and stage III). For those who received ACT, regimens used, drug doses, number of cycles, toxicity, and reasons for dose reduction or treatment interruption were recorded. Disease-free survival (DFS) and overall survival (OS) were calculated with the Kaplan-Meier method.
Out of 96 eligible pts, median age 62 years, 36 received ACT after loco-regional treatment. Median DFS was 29.6 months (95 % CI 13.2-46.0) in pts receiving ACT and 7.8 months (95 % CI 3.9-11.7) in untreated pts (p < 0.0001); median OS was 67.0 months (95 % CI 25.4-108.6) in treated and 33.7 months (95 % CI 23.3-44.2) in untreated pts (p = 0.005). Among pts receiving ACT, a significant difference in DFS was observed between pts with limb/girdle disease (median DFS 82.4 months; 95 % CI 0.0-184.7) and pts with other primary sites (median DFS 18.3 months; 95 % CI 8.0-28.5) (p = 0.052). Grade ≥3 toxicities occurred in 20 pts (20.8 %), leading to dose reductions, delays, and treatment discontinuation in five cases. There was no treatment-related death.
Our data confirm benefit of ACT with regard to DFS and OS in pts with high-risk STS, greatest for limb/girdle STS.
辅助化疗（ACT）在软组织肉瘤（STS）治疗中的作用并非标准治疗方案。我们在临床实践中研究了ACT对接受手术治疗的高危STS患者的有效性和耐受性。
回顾了2003年1月1日至2012年7月7日转诊至帕多瓦威尼斯肿瘤研究所的局限性STS患者的病历。收集高危STS患者（肿瘤大小≥5 cm、高级别且为III期）的数据。对于接受ACT的患者，记录所使用的治疗方案、药物剂量、周期数、毒性以及剂量减少或治疗中断的原因。采用Kaplan-Meier方法计算无病生存期（DFS）和总生存期（OS）。
在96例符合条件的患者中，中位年龄62岁，36例患者在局部区域治疗后接受了ACT。接受ACT的患者中位DFS为29.6个月（95% CI 13.2 - 46.0），未接受治疗的患者中位DFS为7.8个月（95% CI 3.9 - 11.7）（p < 0.0001）；接受治疗的患者中位OS为67.0个月（95% CI 25.4 - 108.6），未接受治疗的患者中位OS为33.7个月（95% CI 23.3 - 44.2）（p = 0.005）。在接受ACT的患者中，肢体/带疾病患者（中位DFS 82.4个月；95% CI 0.0 - 184.7）与其他原发部位患者（中位DFS 18.3个月；95% CI 8.0 - 28.5）之间观察到DFS存在显著差异（p = 0.052）。20例患者（20.8%）发生≥3级毒性反应，导致5例患者剂量减少、治疗延迟和治疗中断。无治疗相关死亡。
我们的数据证实了ACT对高危STS患者的DFS和OS有益，对肢体/带STS患者益处最大。
