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Combined chemotherapy and surgery improve post-radiation sarcoma prognosis
Among the 52 patients with sarcomas studied in this award-winning investigation, limb salvage was possible in 32 patients, investigators reported.
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Long-term survivorship was increased in patients with post-radiation sarcoma if they had bone sarcoma or underwent surgery combined with chemotherapy, according to researchers at Istituto Ortopedico Rizzoli in Bologna.
“Prognosis for patients with post-radiation sarcomas is still poor compared to primary sarcomas, but it remarkably improved with combined chemotherapy and surgery over time,” Pietro Ruggieri, MD, PhD, said.
At 15.1 years mean after radiation therapy performed with a mean radiation exposure dose of 33 Gy, the 52 patients that Ruggieri and colleagues studied developed either bone or soft tissue sarcomas sometime between 1985 and 2011. The bone sarcomas most commonly occurred in the femur or pelvis (38), according to the results, with soft tissue sarcoma (7) seen most often in the thigh.
Images: Pala E
The retrospective study the investigators conducted was selected as the top paper at the 13th EFORT Congress.
“The only significant univariate predictor of survival [was] the type of sarcoma and the treatment,” Ruggieri said at the meeting.
His study, in which patients were followed up for 3.7 years mean after sarcoma treatment, revealed that bone sarcoma, and treatment with chemotherapy and surgery, were associated with the best prognosis.
No multivariate predictor was found to affect survival, Ruggieri said, although he noted that sarcoma and histology nearly reached significance as predictors of survival in the study.
The results showed 13 patients died within 1 year of diagnosis.
At the latest follow-up, there was no evidence of disease in 17 patients, 7 patients were alive with disease, and 25 patients had died, according to Ruggieri.
Limb salvage was possible in 31 cases and 14 patients underwent an amputation, Ruggieri said. Of the 38 patients with bone sarcomas, 12 patients had their limbs amputated. Among the seven soft tissue sarcomas identified in 7 patients in the study, 5 patients underwent limb salvage and 2 patients had an amputation, he noted. – by Jeff Craven
- Reference:
- Ruggieri P. Paper #12-2164. Presented at: 13th EFORT Congress; May 23-25, 2012; Berlin.
- For more information:
- Pietro Ruggieri, MD, PhD, can be reached at Department of Orthopaedic Surgery, University of Bologna, Istituto Ortopedico Rizzoli, Bologna, Italy; email: pietro.ruggieri@ior.it.
Disclosure: Ruggieri has no relevant financial disclosures.