Definitive radiotherapy and Single-Agent radiosensitizing Ifosfamide in Patients with localized, irresectable Soft Tissue Sarcoma: A retrospective analysis

Abstract

Background and PurposeStandard therapy for soft-tissue sarcomas remains complete resection. For primary radiotherapy local control rates of 30-45% have been reported. We analyzed retrospectively 11 cases of radiochemotherapy with single-agent ifosfamide in patients with macroscopic soft-tissue sarcomas.Patients and MethodsThe patients were treated in irresectable high risk situations. Radiation therapy was performed with median 60 Gy. During the first and fifth week the concomitant chemotherapy with ifosfamide was added. Two patients received trimodal therapy with additional regional hyperthermia.ResultsThe therapy was completed in 73% of the patients. Average local control time was 91 months, median disease-free-survival/overall-survival was 8/26 months. Five-year rates for local control/disease free survival/overall survival were 70%/34%/34%. The limited prognosis is mainly caused by systemic treatment failure.ConclusionsThe data strongly suggest a better outcome of radiochemotherapy with ifosfamide compared to radiotherapy alone and radiotherapy in combination with other radiosensitizers.

Radiosensitizing effect of intratumoral interleukin-12 gene electrotransfer in murine sarcoma

“…Radiosensitization of sarcomas is relevant in tumors that exceed the size for therapeutic effectiveness of surgery or radiotherapy as a sole treatment [25-27]. Intratumoral gene therapy with IL-12 may in such cases, as demonstrated in this study, contribute to the antitumor effectiveness of radiotherapy for effective local tumor control.…”

“…In addition, in both tumor models, systemic release of IL-12 had a good radiosensitizing effect [17]. Sarcomas are a specific clinical situation in which tumor irradiation alone cannot provide suitable local control of larger, unresectable tumors [25-27]. Combining irradiation with intratumoral IL-12 gene electrotransfer in order to obtain a local radiosensitizing effect could thus be beneficial for the treatment of bulky sarcomas.…”

Ionizing radiation, ion transports, and radioresistance of cancer cells

“…Preoperative radiotherapy is applied in rectal cancer (Sauer et al, 2012), postoperative treatment in breast cancer (Darby et al). Yet, also rare tumor entities like sarcoma and small cell carcinoma are treated with radiotherapy (Eckert et al, 2010a,b; Muller et al, 2012). Despite modern radiation techniques and advanced multimodal treatments local failures and distant metastases often limit the prognosis, especially due to limited salvage treatments (Muller et al, 2011; Zhao et al, 2012).…”

Rethinking Alkylating(-Like) Agents for Solid Tumor Management

“…Modulation of the tumor response to RT can be achieved by resorting to various antineoplastic agents and has been extensively investigated in alkylating agents and platinum-based strategies with the aim of amplifying the differential effects between tumor and normal cells [25][26][27][28]. Due to their ability to form DNA adducts leading to double-strand breaks and the heavy platinum atom that locally enhances the effect of external beam radiation respectively, alkylating agents and platinum compounds are particularly used in combination with RT as effective radiosensitizing chemotherapy [25,[27][28][29]. Clinical studies have further evidenced the superior efficacy of concomitant chemoradiotherapy in various solid tumors compared to RT alone [25,26,30].…”