Hyperthermia in combination with radiotherapy and chemotherapy in tissue sarcomas of trunk and limbs
Gian Marco Petrianni ,
Italy
PO-1565
Abstract
Hyperthermia in combination with radiotherapy and chemotherapy in tissue sarcomas of trunk and limbs
Authors: pasquale trecca1, Michele Fiore2, Gabriele D'Ercole3, Gian Marco Petrianni3, Pierluigi Falco3, Carlo Greco3, Edy Ippolito4, Sergio Valeri5, Bruno Vincenzi6, Sara Ramella3
1Campus Bio-Medico University Of Rome, Radiation Oncology, Rome, Italy; 2Campus Bio-Medico University of Rome, Radiation Oncology, rome, Italy; 3Campus Bio-Medico University of Rome, Radiation Oncology, Rome, Italy; 4Ippolito, Radiation Oncology, Rome, Italy; 5Campus Bio-Medico University of Rome, Surgery, Rome, Italy; 6Campus Bio-Medico University of Rome, Medical Oncology, Rome, Italy
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Purpose or Objective
The aim of the study is to analyze toxicity and efficacy of addition of HyperThermia (HT) to both radiotherapy (RT) and chemotherapy (CT) in patients affected by Soft Tissue Sarcomas (STS) localized to the trunk and limbs.
Material and Methods
We retrospectively investigated 21 patients (10 males and 11 females, all with Performance Status ECOG 0-1), affected by STS treated with HT combined with RT and/or CT. The mean age was 61 years (range, 43-87). HT session was performed immediately after RT and within three hours from the administration of chemotherapy. The duration of each HT session varied from 70 to 90 minutes to guarantee that target temperature was greater than 40 ° for at least 60 minutes. BSD-500 or BSD-2000 system were used depending on depth of lesion.
Results
The most represented histology was pleomorphic undifferentiated sarcoma.
Three patients had stage I-II disease, 16 ( patients III A/B disease and 2 stage IV for concomitant lung metastases. In 10 patients the lesion treated was the primary tumor and in 11 a relapse of the disease. The mean target was 8.8 cm (range 1-20 cm).
HT was associated to RT in 9 patients, to radiochemotherapy (gemcitabine-based) in 6 patients, to CT in one patient. 5 patients underwent CT (anthracycline and ifofosfamide) following by RT and HT.
In 16 patients, the intent of treatment was neoadjuvant, in 2 postoperative after incomplete resection and in 3 cases for unresectable disease. Mean radiation dose was 52 Gy (range 48-60 Gy).
19 patients were treated with superficial HT and 2 with deep HT.
No skin toxicity greater than grade 2 was detected and only one patient had hematological toxicity greater than grade 3. Among 16 patients treated with neoadjuvant purpose 13 underwent surgery and 3 are going to be evaluated for surgery.
In all 13 cases R0 resection was obtained and in 5 cases (38.5%) a complete pathological response was reported.
With a median follow-up of 22.1 months, 6/21 (28.5%) patients had a progression of disease, 4 a distant progression (3 lung and 1 lung and abdomen), among these 1 had also a local progression. 2 patients had only local progression (in 1 case out filed recurrence in the other case patient was treated without RT). Overall, the local control rate was 85.7%.
Conclusion
In our experience, the integration between HT, radiotherapy and chemotherapy in patients affected by STS of trunk and extremities was feasible achieving a good local control.
However, a larger number of patients and a long follow-up are needed to better estimate features of integration of HT radiotherapy and chemotherapy.