Feasibility and Activity of Concurrent Neoadjuvant Chemotherapy and Radiotherapy in Patients with High-risk Soft-Tissue Sarcoma
Year: 2026
Type: article
Abstract: PURPOSE: The ISG-STS 1001 was an international, randomized, phase III trial for localized, high-risk, soft-tissue sarcoma comparing neoadjuvant chemotherapy (ChT) with epirubicin and ifosfamide (EI) versus a histology-tailored regimen. The trial also included a cohort of patients not randomized but just registered and treated with EI. In this study, we analyzed the tolerability and activity of concurrent EI and radiotherapy (RT) in the ISG-STS 1001 trial. PATIENTS AND METHODS: EI consisted of epirubicin 120 mg/m2 plus ifosfamide 9 g/m2 per cycle. RT was delivered at a dose of 44 to 50 Gy preoperatively or 60 to 66 Gy postoperatively. ChT dose intensity (DI), grade ≥3 hematologic toxicities, acute RT-related toxicities, postoperative local complications, and radiologic response by RECIST were compared between the group of patients receiving concurrent preoperative ChT and RT (ChT/RT group) and the group receiving preoperative ChT alone (ChT group). RESULTS: Among the 548 patients enrolled in the ISG-STS 1001 trial, 287 were included in the current analysis (146 received preoperative RT). The median ChT DI was >90% in both groups. Hematologic toxicities were comparable between the 2 groups. With regard to postoperative complications, a higher number of wound dehiscence (9% vs. 3.5%, respectively; P = 0.06) and seroma (10.4% vs. 2.8%, respectively; P = 0.01) were observed in the ChT/RT group compared with the ChT group. A statistically significant association between RECIST response and preoperative RT was found (20.3% and 9.8% in the ChT/RT and ChT groups, respectively; P = 0.02). CONCLUSIONS: Concurrent EI and RT is feasible and safe, resulting in an increased proportion of dimensional responses.
Source: Clinical Cancer Research
Authors: Elena Palassini, Sara Pizzamiglio, Emanuela Palmerini, Vittorio Quagliuolo, Javier Martin-Broto, Antonio Lopez Pousa, Sandra Aliberti, Antonella Brunello, Jean-Yves Blay, Oscar Tendero, Robert Diaz Beveridge, Virginia Ferraresi, Iwona Lugowska, Claudia Sangalli, Sandro Pasquali, Valeria Duroni, Giuseppe Bianchi, Davide Maria Donati, Andrea Marrari, Jean Michel Coindre, Silvia Bagué, Valeria Fontana, Carlo Morosi, Silvia Stacchiotti, Angelo Paolo Dei Tos, Paolo Verderio, Paolo Giovanni Casali, Alessandro Gronchi
Institutions: Fondazione IRCCS Istituto Nazionale dei Tumori, University of Miami, IRCCS Humanitas Research Hospital, Hospital Universitario Fundación Jiménez Díaz, Hospital de Sant Pau, Candiolo Cancer Institute, Istituto Oncologico Veneto, Lyon 1 Université, Centre Léon Bérard, Hospital Universitario Son Espases, Hospital Universitari i Politècnic La Fe, Instituto Nazionale Tumori Regina Elena, The Maria Sklodowska-Curie National Research Institute of Oncology, Istituto Ortopedico Rizzoli, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Institut Bergonié, Universitat Autònoma de Barcelona, Ospedale Policlinico San Martino, University of Padua
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: European Commission
Award: G5802042430
OpenAlex ID: W7171831642
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