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PRIMARY CHEMOTHERAPY (CT) TOXICITY AND PREOPERATIVE RADIATION THERAPY (RT) IN HIGH-RISK ADULT SOFT TISSUE SARCOMAS: A REPORT FROM THE ITALIAN SARCOMA GROUP AND THE SPANISH SARCOMA GROUP TRIAL
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PRIMARY CHEMOTHERAPY (CT) TOXICITY AND PREOPERATIVE RADIATION THERAPY (RT) IN HIGH-RISK ADULT SOFT TISSUE SARCOMAS: A REPORT FROM THE ITALIAN SARCOMA GROUP AND THE SPANISH SARCOMA GROUP TRIAL Stefano Ferrari, Elena Palassini, Antonino DePaoli, Isabel Sevilla*, Javier MartinezTrufero*, Enza Barbieri, Sergio Frustaci, Alexia Bertuzzi, Annalisa Nobile, Emanuela Palmerini, Silvia Stacchiotti, Xavier Martin Broto*, Paolo Casali, Piero Picci Alessandro Gronchi. ISG - *GEIS
Objective: To evaluate the chemotherapy-related toxicity and protocol compliance in patients with high-risk extremity soft tissue sarcoma preoperativelytreatedwithcombinedchemotherapy and radiotherapy RT SURG EI x 3 SURG RT R Biopsy RT SURG EI x 3 EI x 2 SURG RT EI = epiDOX 120 mg/sqm + IFX 9,000 mg/sqm + GCSF q 21 days RT ( total dose of 44 to 50.4 Gy) was given preoperatively at the discretion of the treating physician
Chemotherapy-related bone marrow toxicity and protocol compliance assessment Incidence (per patient) of grade 3-4 hematologic toxicity (NCI CTC version 2.0) Time to Chemotherapy (TCT) : Months from start to end of CT Time to Surgery (TTS) : Months from start of chemotherapy to surgery
Chemotherapy-related bone marrow toxicity and protocol compliance Chemotherapy Dose Modification: 22%
Chemotherapy-related bone marrow toxicity and protocol compliance Radiotherapy
Chemotherapy-related bone marrow toxicity and protocol compliance Sex
Chemotherapy-related bone marrow toxicity and protocol compliance Age
Chemotherapy-related bone marrow toxicity and protocol compliance Multivariate analysis Preoperative RT prolonged TTS and increased the incidence of PLT G3-4 toxicity. The female sex and older age significantly increased the incidence of hematological toxicity.
Multivariate analysis - Timetosurgery, TimetoChemotherapy TimetoSurgery p<0,0005 TimetoChemo P : NS ANOVA factorial via General Linear model
Multivariate analysis - BoneMarrowtoxicity LogisticRegregression-Logisticbackwardmethod
Chemotherapy-related toxicity and protocol compliance in patients with high-risk extremity soft tissue sarcoma preoperativelytreatedwithcombinedchemotherapy and radiotherapy In adult patients with high-risk soft tissue sarcomas, preoperative radiation therapy can be combined with an intensive primary chemotherapy with an acceptable toxicity profile and a slight (2 weeks) delay of the time of surgery. Female sex and older age are at higher risk of hematological toxicity stefano.ferrari@ior.it
Woundcomplications Incidenceofwoundcomplications: 39 (18%) of 221 evaluated