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At least 19 recordsLinked to original sources
PubMed1978

The role of radiation therapy in the treatment of soft tissue sarcomas of childhood.

The treatment of soft tissue sarcomas in children at the Joint Center for Radiation Therapy, Children's Hospital Medical Center, and the Sidney Farber Cancer Institute from 1970 to 1976 has been reviewed. Twenty-seven patients were diagnosed with rhabdomyosarcoma, and twenty patients were diagnosed with soft tissue sarcomas of other histologies. An aggressive, combined modality therapeutic approach was applied in the treatment of all patients with emphasis placed on conservation of function. Of irradiated patients, local control was achieved in 96% of those with rhabdomyosarcoma and 85% in other sarcomas. Cumulative relapse-free survival (actuarial) at 5 years is projected at 65% for the rhabdomyosarcoma patients and at 63% for the other sarcoma patients. Although there were differences in chemotherapy regimens (vincristine, actinomycin-D and cyclophosphamide for rhabdomyosarcoma and adriamycin and DTIC for other soft tissue sarcomas), the surgical and radiation therapeutic approaches are similar for both groups. The high probability of local control using function-conserving surgery and high dose radiation therapy supports this emerging approach. Improvements in survival will require better control of metastatic disease.

Adolescent↗
PubMed1976

Lymphatic dissemination of bone and soft tissue sarcomas: a lymphographic investigation.

The series consisted of 132 patients, 61 with primary bone sarcomas and 71 with primary soft tissue sarcomas. The patients were all evaluated by lymphography. The investigation included both patients who had not yet been treated and patients with suspected or confirmed metastases. All tumour diagnoses were confirmed microscopically. The findings as regards dissemination were based on clinical examinations, laboratory tests, roentgen examinations and lymphographies. In some cases, lymph node biopsies and surgical observations were also used. A total of 151 lymphographies were performed and 281 follow-up films taken. Preoperative lymphography was performed using the technique introduced by Kinmonth. For postoperative lymphography on the stumps of amputated extremities, two simple but useful methods were developed, which are presented here. Changes in the lymphographic appearance of lymph node metastases, the occurrence of new metastases, and the results of treatment were assessed by survey films and repeat lymphography. The generally accepted criteria for metastasis were used as a basis for the analysis of the lymphographic findings. The results may be summarized as follows: 1. Incidence of lymphatic dissemination. Different sarcomas varied greatly in their clinical course, including the frequency of dissemination. The lymphatic involvement in the metastatic cases was as follows: Bone sarcomas: 16 out of 28 (Table 10); of these, 13 were to regional lymph nodes, 8 to distant nodes and 5 to both (Table 14). Soft tissue sarcomas: 24 out of 40 (Table 11). All 24 had metastases in regional nodes, and 8 in distant nodes as well (Table 15). The highest frequencies of lymphatic spread in the different metastasized tumours were found to be: Bone sarcomas: reticulosarcoma 100%, Ewing's sarcoma 50%, osteosarcoma 47%. Soft tissue sarcomas: rhabdomyosarcoma 100%, synovial sarcoma 80%, neurogenic sarcoma 78%, leiomyosarcoma 67%. 2. Time-relation between lymphatic and haematogenic dissemination; The tendency to metastasize first via the lymphatics or via the blood vessels varied. Half of the cases of Ewing's sarcoma and reticulosarcoma had evidence of lymphatic spread before blood-borne metastases were detected. In the osteosarcoma cases, however, lymphatic dissemination was always preceded by haematogenic spread (Table 12). In synovial sarcoma, rhabdomyosarcoma and neurogenic sarcoma, the first dissemination was more frequently lymphatic than haematogenic (Table 13). 3. Possible existence of special lymphographic features of sarcoma metastases. Only reticulosarcoma displayed special characteristics. The lymph node metastases of reticulosarcoma of bone had lymphographic appearances similar to those found in reticulosarcoma of soft tissue or lymph node origin (Fig. 12). The lymph node metastases of other primary bone and soft tissue sarcomas had no specific lymphographic features and were indistinguishable from carcinomatous metastases (Figs 7, 9, 13, 15, 18, 19, 20, 22, 23). 4...

Adolescent↗
PubMed1978

[Radiotherapy of the soft tissue sarcomas (author's transl)].

Although 82,5% of the total body weight consist of mesenchymal tissues, only 1%--3% of all malignant tumors are soft tissue sarcomas. The necessary irradiation dose can only be determined after an exact histopathological diagnosis; therefore this diagnosis has to be made prior to the radiotherapy. Except the fibro- and liposarcomas, all sarcoma form very early lymphogenic metastases. All sarcomas show a remarquable tendency to form recurrences. Surgery is the primary therapy. After that, an irradiation of the tumor region and the regional lymph nodes should be effected under all circumstances. We have treated and checked up 749 patients. After this therapeutic method, the five-year survival rate in the stages T1 and T2 is 60% for the myxosarcoma, 67% for the angiosarcoma, 41% for the fasciculated sarcoma, 40% for the globocellular sarcoma, 30% for the polymorphous sarcoma, 69% for the fibrosarcoma, and 61% for the leiomyosarcoma.

Fibrosarcoma↗
PubMed1978

Comparison of radiotherapy with and without razoxane (ICRF 159) in the treatment of soft tissue sarcomas.

Comparison of the recurrence rates of soft tissue sarcomas treated by radiotherapy (14 patients) or radiotherapy and synchronous administration of razoxane (19 patients) has shown a statistically significant benefit for those patients treated by the combination. No increase in tissue reactions or adverse side-effects (apart from a readily reversible leukopenia) was observed. The implication is that razoxane acts as a well tolerated adjuvant for radiotherapy.

Adult↗
PubMed1977

Adjuvant role of radiation in soft tissue sarcoma in adults.

Forty-seven patients with soft tissue sarcomas were analyzed retrospectively. Treatment was non-randomized between surgery alone, preoperative radiation of 5,000 rads/5 weeks, postoperative radiation of 6,000 rads/6 weeks following total gross tumor removal, and postoperative radiation (variable dosees) for residual gross or unresectable tumor. Preoperative radiation was not statistically better for local control or survival compared to postoperative radiation after local excision of gross tumor. Wide excision, higher postoperative radiation dosage, and/or enlarged radiation portals perhaps would improve results. Additional adjuvant therapies, such as chemotherapy or immunotherapy, needs to be investigated.

Adult↗
PubMed1978

Actual volume doubling time values for pulmonary metastases from soft tissue sarcomas.

Doubling time values of pulmonary metastases from soft tissue sarcomas were measured. Sixty metastases from 24 patients were measured 79 consecutive times, and, the values for 116 doubling times were calculated. Small volume metastases grew significantly faster (arithmetic mean 29.7 days) than large metastases (arithmetic mean 43.4 days). An assessment with comparative data obtained previously by measuring the doubling time values of pulmonary metastases from osteogenic sarcoma revealed similar growth characteristics. The possible involvment of identical control mechanisms operating in the growth process of pulmonary metastases in both soft tissues and osteogenic sarcomas are discussed.

Adult↗
PubMed1979

Preoperative chemotherapy in soft tissue sarcoma.

The preoperative use of chemotherapy in the management of soft tissue sarcoma is a recent concept in the multidisciplinary management of neoplasia related to the development of more effective drug combinations. The reason for chemotherapy preoperatively is to define the effectiveness of drug treatment, permitting a rational basis for long term adjuvant treatment. In addition, major surgical morbidity may be precluded if chemotherapy is effective, allowing lesser surgical procedures, such as limb-sparing local resection. Patient selection for this approach must be individualized and is based upon the major determinants of prognosis, including the stage of the tumor according to the TNM and G--grade--classification. Radiation therapy is an essential component of the multimodality approach to soft tissue sarcomas, and the interaction of all three therapeutic modalities must provide optimal tumor control and minimal morbidity.

Adult↗
PubMed1979

[Electron microscopy diagnosis of soft tissue sarcoma].

The results of electron microscopy studies of 20 soft tissue sarcomas difficult to diagnose-fibrosarcomas, malignant fibroxanthomas, leiomyosarcomas, rhabdomyosarcomas and malignant schwannomas, are reported. The tumor elements of each of these neoplasms showed rather typical ultrastructural features enabling us to reliably ascertain their histological origin.

Fibroma↗
PubMed1978

Limb salvage using preoperative intraarterial adriamycin and radiation therapy for extremity soft tissue sarcomas.

Surgical therapy has been the accepted method for management of most soft tissue sarcomas of the extremities, although it has been associated frequently with local treatment failure. Even when local control was achieved, over 50% of the patients with soft tissue sarcomas eventually developed and succumbed to distant metastases of their disease. Therefore, single modality therapy for soft tissue sarcomas by operation alone results in an unacceptably high incidence of treatment failure. Fortunately, new adjuvant treatment techniques have been developed that seem to have activity against these neoplasms. It is the purpose of this article to discuss our experience with a number of these techniques.

Doxorubicin↗
PubMed1976

The management of soft-tissue sarcomas of the extremities.

Of fifty-four patients with a soft-tissue sarcoma of an extremity, having a projected five-year survival rate of 62 per cent, forty-six treated by an "adequate" surgical procedure (either radical local resection or ablation at an appropriate level, depending on defined circumstances) had a local recurrence rate of 2 per cent. In the other eight patients, whose surgical procedures were not adequate for one reason or another, the local recurrence rate was 100 per cent. The combined recurrence rate after both the adequate and the inadequate procedures was 16.7 per cent. The recurrences were noted prior to thirty months post-operatively and the metastases, prior to sixty months. Histogenesis of the sarcoma, one or more recurrences after previous operations, and treatment by an immediate definitive procedure at the time of biopsy and diagnosis by frozen section had no significant relationship to the rates of local recurrence or metastasis. Adequate radical local resection controlled these sarcomas as well as ablative surgery in terms of local recurrence and metastasis. The significant factors affecting local recurrence that were identified in this study were the location of the sarcoma and the adequacy of the surgical procedure.

Adolescent↗
PubMed1979

[Panniculitis nodularis febrilis non suppurative in metastasizing soft-tissue sarcoma].

Report of a 28-year-old female patient with a metastasizing soft tissue sarcoma confined to the oral mucosa and subcutis. The basic disease attracted clinical attention as a nodular febrile nonsuppurative panniculitis (Pfeifer-Weber-Christian disease). Perivascular tumor cells in the subcutis obviously induced localized fat necroses. Ultrastructurally, the pathological cells showed no indicative cytological characteristics other than a close association with reticulin fibers. Apparently, a metastasizing tumor disease can be concealed under the clinical picture of a nodular febrile non suppurative panniculitis--as a paraneoplastic syndrome.

Adult↗
PubMed1979

[Immune reactions in assessing the disease prognosis in soft tissue sarcomas].

Under examination were 60 patients with local forms of soft tissue sarcomas of various histological structure. By means of skin delayed hypersensitivity test for dinitrochlorobenzene (DNCB) and tuberculin as well as cell immunity reaction in vitro the immune response was shown to be of value in estimating the prognosis of the disease. The dynamics of immune reactions 2-3 months following the operation proved to be of greatest prognostic value. Among the employed immunological tests the skin test for DNCB and the reaction of spontaneous rosette-forming provided the most comprehensive information as to the control over the clinical course of malignant lesion.

Adolescent↗
PubMed1979

Case-control study: soft-tissue sarcomas and exposure to phenoxyacetic acids or chlorophenols.

In 1977 a number of patients with soft-tissue sarcomas and previous exposure to phenoxyacetic acids were described. Following from these observations a matched case-control study was made. Exposure to chlorophenols was also included in this study. The results showed that exposure to phenoxyacetic acids or chlorophenols gave an approximately 6-fold increase in the risk for this type of tumour. It was not possible to determine, however, whether the carcinogenic effect was exerted by these compounds or by impurities such as chlorinated dibenzodioxins and dibenzofurans that in almost all cases were part of the commercial preparations.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1979

[Computed tomography of soft tissue sarcomas (author's transl)].

CT findings in 50 patients with histologically verified soft tissue sarcomas are presented. In nearly all the cases the cross-sectional view and the higher resolution of density make it possible to determine exactly location of the tumors, their size and relationship to adjacent structures. Thus CT opens a new dimension, which is of great value for staging and therapy treatment planning. The high rank of CT in the follow-up after therapy and the detection of recurrent tumor is demonstrated. The contribution of CT, however, to the anatomic characteristics and its prospective value with the regard to soft tissue tumor is less important. Further limits of the method are discussed.

Humans↗