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Review
. 2016 Nov;78(5):895-919.
doi: 10.1007/s00280-016-3055-1. Epub 2016 May 20.

Looking for answers: the current status of neoadjuvant treatment in localized soft tissue sarcomas

Michael J Nathenson  1 , Edward Sausville  2
Affiliations
Review

Looking for answers: the current status of neoadjuvant treatment in localized soft tissue sarcomas

Michael J Nathenson et al. Cancer Chemother Pharmacol. 2016 Nov.

Abstract

Purpose: Sarcomas are a rare and heterogeneous variant of cancer. The standard of care treatment involves surgical resection with radiation in high-risk patients. Despite appropriate treatment approximately 50 % of patients will suffer and die from recurrent disease. The purpose of this article is to review the current evidence concerning the use of neoadjuvant chemotherapy with or without radiation in soft tissue sarcomas.

Methods: An in-depth literature search was conducted using Ovid Medline and PubMed.

Results: The most active chemotherapeutic agents in sarcoma are anthracyclines and ifosfamide. Adjuvant chemotherapy trials show only minimal benefit. Neoadjuvant chemotherapy offers the potential advantage of reducing the extent of surgery, increasing the limb salvage rate, early exposure of micrometastatic disease to chemotherapy, and assessment of tumor response to chemotherapy. Some retrospective and phase II trials suggest a benefit to neoadjuvant chemotherapy. Unfortunately, no clearly positive phase III prospectively randomized trials exist for neoadjuvant therapy in soft tissue sarcomas.

Conclusions: The current neoadjuvant chemotherapy trials that do exist are heterogeneous resulting in conflicting results. However, neoadjuvant chemotherapy with or without radiation can be considered in patients with high-risk disease in an attempt to improve long-term outcomes.

Keywords: Chemotherapy; Neoadjuvant; Radiation; Sarcoma; Sarcoma soft tissue.

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Conflict of interest statement

Compliance with ethical standards

Conflict of interest There are no conflicts of interests to report, and no disclaimers.

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