Caffeine-potentiated radiochemotherapy and function-saving surgery for high-grade soft tissue sarcoma

Caffeine, which has a DNA-repair inhibiting effect, enhances the cytocidal effects of anticancer drugs and radiation. We present a preliminary report on the results of a new treatment, "radiochemotherapy combined with caffein e" (K3 protocol), for high-grade soft tissue sarcomas. Seventeen patients w ith various high-grade soft tissue sarcomas were included in this study. Pr eoperatively, three to five courses of intra- arterial chemotherapy using c isplatin, caffeine and doxorubicin after radiation therapy were administere d. Following the preoperative therapy, function-saving surgery was performe d for all cases. Complete response was observed in sir patients, partial re sponse in str and no change in five. The effectiveness rate of caffeine-pot entiated radiochemotherapy was therefore 71%. The histological response for radiochemotherapy was better than that for chemotherapy alone, that is, to tal tumor necrosis was identified in six patients and over 90% necrosis in another six. Complications resulting from the preoperative radiation compri sed of serious inflammation in three patients and skin necrosis in another three. Twelve patients have remained free of disease two patients are alive with disease and three have died of metastatic disease with a mean follow- up period of 36 months. There was no local tumor recurrence. These prelimin ary findings suggest that caffeine- potentiated radiochemotherapy contribut ed to a satisfactory local response and the success of function-saving surg ery for high-grade soft tissue sarcomas.