부산대학교 도서관

From Nov. 1990 to Oct. 1994 a total of 97 (72% pretreated) adults with locally-advanced, nonmetastastic soft tissue sarcomas were entered in a protocol (RHT-91) involving regional hyperthermia (RHT) combined with systemic preoperative chemotherapy followed by surgery. Primary tumor grading (84 patients had grade II or III), tumor size (8cm) and/or extracompartmental tumor extension (46 patients), or local recurrences (51 patients) were defined as high-risk factors. RHT was produced by an electromagnetic regional heating device (BSD-2000 system). For systemic chemotherapy the 97 patients received etoposide/ifosfamide/doxorubicin (EIA) with RHT being given on day 1 and 4 in repeated cycles (EIA/RHT) every 3 weeks. By the cutoff date for this analysis (Oct. 1994), 70 patients had undergone surgery after receiving EIA chemotherapy combined with RHT; 60 tumors except 10 could be resected without amputation. In 27 patients no further surgical procedure was performed. In 92 evaluable patients, the clinical response rate is 34% (1 CR = complete, 15 PR = partial, 17 MR = minor). 41 patients showed stable disease (NC) and 18 patients showed tumor progression (PD). Pathologic response to preoperative thermochemotherapy was evaluable in 70 patients with 30 responders (=43%) having either 50% histologic necrosis (FHR) within the resected tumors (20 patients) or pathological complete response (pCR) at the time of surgery (10 patients). All patients received-whenever possible-adjuvant chemotherapy and postoperative radiation. At the cutoff date, best response was obtained by the strategy of the RHT-91 study in 40 patients (=41%) showing no evidence of disease (NED) (median observation time = 18 months). An updated report will be given in regard to overall survival for non chemo-pretreated (n=73) and chemopretreated (n=24) patients. The protocol of a randomized multicenter trial (RHT-95) in patients with primary or recurrent high-risk soft tissue sarcomas will be presented to further test the potential of preoperative thermochemotherapy compared to neoadjuvant chemotherapy alone in regard to local control and survival.Supported by grant M19/88/Wi9 from the Deutsche Krebshilfe, Bonn.