Long-term results of preoperative intra-arterial doxorubicin combined withneoadjuvant radiotherapy, followed by extensive surgical resection for locally advanced soft tissue sarcomas of the extremities

Background and purpose: In the 1980s a combined modality therapy of intraar terial doxorubicin, neoadjuvant radiotherapy and surgery was initiated at t he Groningen University Hospital as a limb-saving treatment for locally adv anced, primarily irresectable high-grade soft tissue sarcomas (STS) of the extremities. This study presents the short- and long-term results. Patients and methods: Between 1983 and 1987, 11 patients were treated with intraarterial doxorubicin, preoperative radiotherapy (10 x 3.5 Gy) and surg ical resection. Non-radical resections received additional postoperative ra diotherapy of 20-30 Gy. Results: The limb-salvage rate was 91%, without local recurrences during a median follow-up of 84 months. Six patients died (55%); five from metastati c disease (45%). There were five long-term survivors with a median follow-u p of 10 years. Three patients (60%) suffered serious late complications, re sulting in disabilitating limb function. Conclusion: Although this approach is feasible as a limb-saving treatment f or these unfavorable STS, long-term morbidity is high. (C) 1999 Elsevier Sc ience Ireland Ltd. All rights reserved.