Chimiothérapie néoadjuvante des sarcomes

Jean Yves Blay, Sylvie Bonvalot, Jérôme Fayette, Eberhart Stockle, Isabelle Ray-Coquard, Jean Marie Coindre, Florence Duffaud, Sophie Taieb, Marie Pierre Sunyach, Dominique Ranchere, Pierre Meeus, Axel Le Cesne, Binh Nguyen Bui

    Résultats de recherche: Contribution à un journalArticleRevue par des pairs

    13 Citations (Scopus)

    Résumé

    This document describe s the proposed clinical practices guidelines for neoadjuvant chemotherapy in soft tissue sarcomas proposed by the French Sarcoma Group. Neo-adjuvant chemotherapy remains an experimental therapeutic procedure in soft tissue sarcomas. Neoadjuvant chemotherapy may be proposed in three different types of situations: 1) a locally advanced tumor, non accessible to R0 or 1 removal of the lesion. Its objective is there to allow for R1 or R1 surgical removal of the tumor. 2) A locally advanced tumor, accessible to R0 or 1 removal of the lesion, but with a mutilating surgery (amputation). Its objective is there to allow for R0 or R1 conservative surgical removal of the tumor. In both situation, the strategy should be discussed beforehand in a multidisciplinary specialized consultation for sarcoma. 3) In the case where complete (R0 or R1) surgical removal of the tumor can be performed, neooadjuvant chemotherapy has no demonstrated role. The only randomized phase III clinical trial testing neo-adjuvant chemotherapy in this setting, i.e. the STBSG 62871 STBSG trial, failed to demonstrate any benefit in terms of overall or progression free survival. The slection of the type of chemotherapy regimen given in the neoadjuvant setting should be discussed in a multidisciplinary setting, considering the age and the general status of the patient; young patients, without associated concomittent illnesses should be proposed for a combined chemotherapy regimen, combiningdoxorubicin (≥ 50 mg/m2) andifosfamide (> 5 g/m2) on the basis of randomized trials demonstrating an improvement of response rate versus single agent therapy with doxorubine. In elderly and/or frail patients, conversely, single agent doxorubicin may be the preferred option.

    Titre traduit de la contributionNeoadjuvant chemotherapy in sarcoma
    langue originaleFrançais
    Pages (de - à)1093-1098
    Nombre de pages6
    journalBulletin du Cancer
    Volume93
    Numéro de publication11
    Les DOIs
    étatPublié - 1 nov. 2006

    mots-clés

    • Chemotherapy
    • Doxorubicin
    • Ifosfamide
    • Neoadjuvant
    • R0
    • R1
    • Sarcoma
    • Surgery

    Contient cette citation