Adjuvant CYVADIC chemotherapy for adult soft tissue sarcoma--reduced local recurrence but no improvement in survival: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group.

2.50
Hdl Handle:
http://hdl.handle.net/10541/96992
Title:
Adjuvant CYVADIC chemotherapy for adult soft tissue sarcoma--reduced local recurrence but no improvement in survival: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group.
Authors:
Bramwell, Vivien H C; Rouesse, J; Steward, William P; Santoro, A; Schraffordt-Koops, H; Buesa, J; Ruka, W; Priario, J; Wagener, T; Burgers, M
Abstract:
PURPOSE: To evaluate the benefit of adjuvant chemotherapy in adult patients with soft tissue sarcomas. The principal end points were freedom from local recurrence and/or metastases and overall survival. PATIENTS AND METHODS: Between January 1977 and June 1988, 468 patients entered this randomized study and 317 were considered eligible. Following complete surgical resection with or without radiotherapy, outcome in 145 eligible patients receiving cyclophosphamide 500 mg/m2 intravenously (IV) bolus on day 1, vincristine 1.4 mg/m2 IV bolus on day 1, doxorubicin (Adriamycin; Adria Laboratories, Columbus, OH) 50 mg/m2 IV bolus on day 1, and dacarbazine (DTIC) 400 mg/m2 by 1-hour infusion on days 1 to 3 (CYVADIC) cycles repeated every 28 days for eight courses was compared with that in 172 control patients. RESULTS: With a median follow-up duration of 80 months (range, 39 to 165), actuarial percentage survival figures at 7 years were compared. Relapse-free survival rates were higher for CYVADIC, 56% versus 43% (P = .007), and local recurrence was significantly reduced in the CYVADIC arm at 17% versus 31% (P = .004). In contrast, distant metastases occurred with similar frequency in both arms, 32% for CYVADIC versus 36% for control patients (P = .42), and overall survival rates were not significantly different at 63% versus 56% (P = .64). A reduction in local recurrence was only apparent in the group of head, neck, and trunk sarcomas (P = .002), but not in limb tumors (P = .31). CONCLUSION: Adjuvant chemotherapy with CYVADIC cannot be recommended outside the context of a clinical trial. Experience from this study has been used to plan a trial of neoadjuvant chemotherapy with doxorubicin/ifosfamide, which is currently in progress.
Affiliation:
London Regional Cancer Centre, Canada.
Citation:
Adjuvant CYVADIC chemotherapy for adult soft tissue sarcoma--reduced local recurrence but no improvement in survival: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. 1994, 12 (6):1137-49 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
Jun-1994
URI:
http://hdl.handle.net/10541/96992
PubMed ID:
8201375
Type:
Article
Language:
en
ISSN:
0732-183X
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Full metadata record

DC FieldValue Language
dc.contributor.authorBramwell, Vivien H Cen
dc.contributor.authorRouesse, Jen
dc.contributor.authorSteward, William Pen
dc.contributor.authorSantoro, Aen
dc.contributor.authorSchraffordt-Koops, Hen
dc.contributor.authorBuesa, Jen
dc.contributor.authorRuka, Wen
dc.contributor.authorPriario, Jen
dc.contributor.authorWagener, Ten
dc.contributor.authorBurgers, Men
dc.date.accessioned2010-04-21T10:43:25Z-
dc.date.available2010-04-21T10:43:25Z-
dc.date.issued1994-06-
dc.identifier.citationAdjuvant CYVADIC chemotherapy for adult soft tissue sarcoma--reduced local recurrence but no improvement in survival: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. 1994, 12 (6):1137-49 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid8201375-
dc.identifier.urihttp://hdl.handle.net/10541/96992-
dc.description.abstractPURPOSE: To evaluate the benefit of adjuvant chemotherapy in adult patients with soft tissue sarcomas. The principal end points were freedom from local recurrence and/or metastases and overall survival. PATIENTS AND METHODS: Between January 1977 and June 1988, 468 patients entered this randomized study and 317 were considered eligible. Following complete surgical resection with or without radiotherapy, outcome in 145 eligible patients receiving cyclophosphamide 500 mg/m2 intravenously (IV) bolus on day 1, vincristine 1.4 mg/m2 IV bolus on day 1, doxorubicin (Adriamycin; Adria Laboratories, Columbus, OH) 50 mg/m2 IV bolus on day 1, and dacarbazine (DTIC) 400 mg/m2 by 1-hour infusion on days 1 to 3 (CYVADIC) cycles repeated every 28 days for eight courses was compared with that in 172 control patients. RESULTS: With a median follow-up duration of 80 months (range, 39 to 165), actuarial percentage survival figures at 7 years were compared. Relapse-free survival rates were higher for CYVADIC, 56% versus 43% (P = .007), and local recurrence was significantly reduced in the CYVADIC arm at 17% versus 31% (P = .004). In contrast, distant metastases occurred with similar frequency in both arms, 32% for CYVADIC versus 36% for control patients (P = .42), and overall survival rates were not significantly different at 63% versus 56% (P = .64). A reduction in local recurrence was only apparent in the group of head, neck, and trunk sarcomas (P = .002), but not in limb tumors (P = .31). CONCLUSION: Adjuvant chemotherapy with CYVADIC cannot be recommended outside the context of a clinical trial. Experience from this study has been used to plan a trial of neoadjuvant chemotherapy with doxorubicin/ifosfamide, which is currently in progress.en
dc.language.isoenen
dc.subjectCancer Recurrenceen
dc.subjectSoft Tissue Canceren
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshChemotherapy, Adjuvant-
dc.subject.meshCyclophosphamide-
dc.subject.meshDacarbazine-
dc.subject.meshDoxorubicin-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshNeoplasm Recurrence, Local-
dc.subject.meshSarcoma-
dc.subject.meshSoft Tissue Neoplasms-
dc.subject.meshSurvival Rate-
dc.subject.meshVincristine-
dc.titleAdjuvant CYVADIC chemotherapy for adult soft tissue sarcoma--reduced local recurrence but no improvement in survival: a study of the European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group.en
dc.typeArticleen
dc.contributor.departmentLondon Regional Cancer Centre, Canada.en
dc.identifier.journalJournal of Clinical Oncologyen
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