Thermo-chemo-radio-therapy in the combined treatment of locally advanced soft tissue sarcomas (STS)

118 patients with locally advanced STS examined and treated in MRRC were analyzed. In group 1 were included 31 patients treated by only surgery (S). The group 2 consisted of 33 patients treated with preoperative chemo-radiotherapy (CRT) followed by S. The group 3 included 22 patients received preoperative thermo-chemo-radiotherapy (TCRT) and S. The group 4 consisted of 32 patients, who received preoperative TCRT and S with intraoperative radiation therapy (IORT). Preoperative TCRT increased number of patients with stage III & IV of tumor therapeutic pathomorphism. TCRT and IORT didn't increase an incidence of complications and allowed to perform an increase organ-saving operations. None of the patients in group with TCRT had local recurrence during 3-5 years. The locoregional-recurrence-free-survival (LRFS), metastasis-free survival and overall survival rates (73-100, 56-88, 68-95%) were higher in group with combined treatment compared to first group (30, 20,5, 29%) respectively.

soft tissues sarcomas, combined treatment, local hyperthermia, radiation therapy, thermo-chemo-radiotherapy

1. Aliev M.D. Sovremennye podkhody k lecheniyu sarkom myagkikh tkanei. Prakticheskaya onkologiya. 2004, t. 5, № 4, s. 250-255.

2. Aliev M.D., Mekhtieva N.I., Bokhyan B.Yu. Faktory prognoza sarkom myagkikh tkanei. Voprosy onkologii. 2005, t. 51, № 3, s. 288-299.

3. Goldobenko G.V., Ivanov S.M., Tkachev S.I., Karapetyan R. M. Luchevoe lechenie bol'nykh s neoperabel'nymi sarkomami myagkikh tkanei s primeneniem elektromagnitnoi gipertermii. Vestnik onkologicheskogo nauchnogo tsentra im. N.N. Blokhina. 1998, № 1, s. 60-64.

4. Davydov M.I., Aksel' E.M. Statistika zlokachestvennykh novoobrazovanii v Rossii i stranakh SNG v 2004 g. Vestnik Rossiiskogo onkologicheskogo nauchnogo tsentra im. N.N. Blokhina RAMN. 2006, t. 17, № 3 (prilozhenie 1), s. 45-66.

5. Ivanov S.M., Tkachev S.I., Bokhyan B.Yu. i soavt. Termoradiokhimioterapiya neoperabel'nykh sarkom myagkikh tkanei. Voprosy onkologii. 2005, t. 51, № 3, s. 350-354.

6. Kiseleva E.S., Goldobenko G.V., Kanaev E.V. i soavt. Luchevaya terapiya zlokachestvennykh opukholei. M.: Meditsina. 1996, 464 s.

7. Kraevskii N.A., Solov'ev Yu.N., Ol'khovskaya I.G., Pokrovskaya N.N. Patomorfoz opukholei. Arkhiv patologii. 1980, t. KhSh, vyp. 8, s. 3-8.

8. Kurpeshev O.K., Berdov B.A. Rezul'taty lokal'noi gipertermii v onkologii //Rossiiskii onkologicheskii zhurnal. 1999, № 2, s. 48-52.

9. Lavnikova G.A. Nekotorye zakonomernosti luchevogo patomorfoza opukholei cheloveka i ikh prakticheskoe ispol'zovanie. Vestnik Akademii meditsinskikh nauk. 1976, № 6, s. 13-19.

10. Fradkin S.Z. Sovremennye aspekty klinicheskoi termoonkologii i tendentsii ee razvitiya. Materialy III s"ezda onkologov i radiologov SNG, 25-28 maya 2004 g Minsk: Tonpik. 2004, chast' 1, s. 143-146.

11. Dewhirst M.W., Poulson J.M., Yu D. et al. Relation between pO2, 31P magnetic resonance spectroscopy parameters and treatment outcome in patients with high-grade soft tissue sarcomas treated with thermoradiotherapy. Int. J. Rad. Oncol. Biol. Phys. 2005, v. 61 (2), p. 480-491.

12. Engellau J., Anderson H., Ridholm A. et al. Time dependence of prognostic factors for patients with soft tissue sarcoma: a Scandinavian Sarcoma Group Study of 338 malignant fibrous histiocytomas. Cancer (Philad.). 2004, v. 100, p. 2233-2239.

13. Fletcher Ch.D.M., Unni K.K., Mertens F. (eds.) World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of Soft Tissue and Bone. Lyon: IARS press. 2002, p, 264-270.

14. Hiraoka M., Nishimura Y., Nagata Y. et al. Clinical results of thermoradiotherapy for soft tissue tumours. Int. J. Hyperth. ermia. 1995, v. 11, № 3, p. 365-377.

15. Issels R.D. Present status of regional Hyperthermia combined chemotherapy in Soft Tissue Sarcomas. New trends in Hyperthermia: from the bench to the bedside. Abstract book of XXVII ICHS Annual Meeting. Florence. 2005, p. 74-75.

16. Issels R.D., Abdel-Rahman S., Wendtner C.M. et al. Neoadjuvant chemotherapy combined with regional hyper-thermia (RHT) for locally advanced primary or recurrent high-risk adult soft-tissue sarcomas (STS) of adults: long-term results of a phase II study. Eur. J. Cancer. 2001, v. 37, p. 1599-1608.

17. Jemal A., Tiwari R.C., Murray T. et al. Cancer statistics, 2004. CA Cancer J. Clin. 2004, v. 54, p. 8.

18. Kaplan E.L., Meier P. Nonparametric estimation from incomplete observations. J. Am. Stat. Ass. 1958. v. 53, p. 457-481.

19. Mullen J.T., Kobayashi W., Harmon D.C. et al. Long-term follow-up of patients treated with neoadjuvant chemotherapy and radiotherapy for large extremity soft tissue sarcomas. Abstract book of 46th ASCO Annual Meeting. Chicago, 2010.

20. Ramanathan R.C., A'Hern R., Fisher C., Thomas J. M. Prognostic index for extremity soft tissue sarcomas with isolated local recurrence. Ann. Surg. Oncol. 2001, v. 8, p. 278-289.

21. Schlemmer M., Wendtner C. M., Issels R. D. Ifosfamide with regional hyperthermia in soft-tissue sarcomas. Oncology. 2003. v. 65 (Suppl 2), p. 76-79.