Chemotherapy versus Non-Chemotherapy in the Treatment of Soft Tissue Sarcoma: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

1. Xinjiang Medical University, Urumqi 830054, China;2. The Affiliated Oncology Hospital of Xinjiang Medical University, Urumqi 830011, China;

Corresponding author：

Keywords：

Soft tissue sarcoma; Chemotherapy; Systematic review

DOI：

10.7507/1672-2531.20100458

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To assess effectiveness of chemotherapy versus non-chemotherapy in the treatment of soft tissue sarcoma.
Methods 　We searched MEDLINE (1966 to Dec. 2008), EMBASE (1984 to Dec. 2008), OVID (1980 to Dec. 2008), CBMdisc (1980 to Dec. 2008), and the Cochrane Central Register of Controlled Trials. We also handsearched Journal of Chinese Oncology, Journal of Chinese Clinical Oncology, and Tumor (from inception to Dec. 2008). The quality of the included studies was evaluated by two reviewers independently and meta-analysis was performed for results of the homogenous studies.
Results 　Six studies involving 836 participants related to primary, high grade, nonmetastatic soft tissue sarcoma were included. All included studies were unclear in reporting randomization and blinding; all studies reported the number and the reason of withdraw; and baseline conditions of all studies were compared. The results of meta-analyses showed that there were no significant differences in 5-year overal survival (RR=0.90, 95%CI0.76 to 1.06), local recurrence (OR=0.69, 95%CI 0.36 to 1.32), distant recurrence (OR=0.83, 95%CI 0.62 to 1.11), and overall recurrence (RR=0.91, 95%CI 0.78 to 1.06) between the chemotherapy group and the control group. But as to 5-year disease-free survival, the chemotherapy group was better than the control group (RR=0.73, 95%CI 0.63 to 0.86).
Conclusion 　There is no advantage for the chemotherapy group over the control group in 5-year overal survival, local recurrence, distant recurrence and overall recurrence. Due to the risk of selection bias, performance bias and published bias, the evidence is not b enough to judge whether chemotherapy is better than control in treating soft tissue sarcoma. Our conclusion suggests that larger-scale randomized trials should be performed in future.

Citation： MA XiaoWei,BAI JingPing,XILIN Boleri,JIANG RenBing,HE ZuSheng. Chemotherapy versus Non-Chemotherapy in the Treatment of Soft Tissue Sarcoma: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2010, 10(5): 618-624. doi: 10.7507/1672-2531.20100458 Copy

1.	胥少汀, 葛宝丰, 徐印坎. 实用骨科学. 北京: 人民军医出版社, 2005: 1539-1585.
2.	Nielsen OS, Judson I, Van Hoesel Q, et al. Effect of high-dose ifosfamide in advanced soft tissue sarcomas: a multicentre phaseⅡstudy of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer, 2000, 36(1): 61-67.
3.	Robinson MH. The management of adult soft tissue sarcomas. Clin Oncol, 1994, 6(3): 183-189.
4.	Vraa S, Keller J, Nielsen OS, et al. Prognostic factors in soft tissue sarcomas: the Aarhus experience. Eur JCancer, 1998, 34(12): 1876-1882.
5.	O’byrne K, Steward WP. The role of adjuvant chemotherapy in the treatment of adult soft tissue sarcomas. CritRev Oncol Hematol, 1998, 27(3): 221-227.
6.	Verweij J, Mouridsen HT, Nielessen OS, et al. The present state of the art in chemotherapy for soft tissue sarcomas in adults: the EORTC point of view. Crit RevOncol Hematol, 1995, 20(3): 193-201.
7.	Coindre JM, Terrier P, Bui NB, et al. Prognostic factors in adult patients with locally controlledsoft tissue sarcoma: A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group. J Clin Oncol, 1996, 14(3): 869-877.
8.	Alvegd TA, Sigurdsson H, Mouridsen H, et al. Adjuvant chemotherapy with doxorubicin in high grade soft tissue sarcoma: a randomized trial of the Scandinavian Sarcoma Group. J Clin Oncol, 1989, 7(10): 1504-1513.
9.	Edmonson JH, Fleming TR, Ivins JC, et al. Randomized study of systemic chemotherapy following complete excision of nonoesseous sarcomas. J Clin Oncol, 1984, 2(12): 1390-1396.
10.	Chang AE, Kinsella T, Glatstein E, et al. Adjuvant chemotherapy for patients with high-grade soft-tissue sarcomas of the extremity. J Clin Oncol, 1988, 6(9): 1491-1500.
11.	Bramwell V, Rouesse J, Steward W, et al. 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. J Clin Oncol, 1994, 12(6): 1137-1149.
12.	Lerner HJ, Amato DA, Savlov ED, et al. Eastern Cooperative Oncology Group: A comparison of adjuvant doxorubicin and observation for patients with localized soft-tissue sarcoma. J Clin Oncol, 1987, 5(4): 613-617.
13.	Frustaci S, Gherlinzoni F, De Paoli A, et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: Results of the Italian randomized cooperative trial. J Clin Oncol, 2001, 19(5): 1238-1247.
14.	Antman KH. Adjuvant therapy of sarcomas of soft tissue. Semin Oncol, 1997, 24: 556-560.
15.	Benjamin RS. Evidence for using adjuvant chemotherapy as standard treatment of soft tissue sarcoma. Semin Radiat Oncol, 1999, 9(4): 349-351.
16.	Cormier JN, Huang X, Xing Y, et al. Cohort analysis of patients with localized, high risk, extremity soft tissue sarcoma treated at two cancer centers: chemotherapy associated outcomes. J Clin Oncol, 2004, 22(22): 4567-4574.
17.	Bramwell VHC. Controversies in Surgical Oncology: Routine anthracyclinebased adjuvant chemotherapy for stage III extremity soft tissue sarcoma. Ann Surg Oncol, 2007, 14: 1254-1256.
18.	Verweij J, Sejnaeve C. The reason for confining the use of adjuvant chemotherapy in soft tissue sarcoma to the investigational setting. Semin Radiat Oncol, 1999, 9: 352-359.
19.	Frustaci S, De Paoli A, Bidoli E, et al. Ifosfamide in the adjuvant therapy of soft tissue sarcomas. Oncology, 2003, 65(Suppl 2): 80-84.
20.	Grobmyer SR, Maki RG, Demetri GD, et al. Neo-adjuvant chemotherapy for primary high-grade extremity soft tissue sarcoma. Ann Oncol, 2004, 15(11): 1667-1672.

1. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学. 北京: 人民军医出版社, 2005: 1539-1585.
2. Nielsen OS, Judson I, Van Hoesel Q, et al. Effect of high-dose ifosfamide in advanced soft tissue sarcomas: a multicentre phaseⅡstudy of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer, 2000, 36(1): 61-67.
3. Robinson MH. The management of adult soft tissue sarcomas. Clin Oncol, 1994, 6(3): 183-189.
4. Vraa S, Keller J, Nielsen OS, et al. Prognostic factors in soft tissue sarcomas: the Aarhus experience. Eur JCancer, 1998, 34(12): 1876-1882.
5. O’byrne K, Steward WP. The role of adjuvant chemotherapy in the treatment of adult soft tissue sarcomas. CritRev Oncol Hematol, 1998, 27(3): 221-227.
6. Verweij J, Mouridsen HT, Nielessen OS, et al. The present state of the art in chemotherapy for soft tissue sarcomas in adults: the EORTC point of view. Crit RevOncol Hematol, 1995, 20(3): 193-201.
7. Coindre JM, Terrier P, Bui NB, et al. Prognostic factors in adult patients with locally controlledsoft tissue sarcoma: A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group. J Clin Oncol, 1996, 14(3): 869-877.
8. Alvegd TA, Sigurdsson H, Mouridsen H, et al. Adjuvant chemotherapy with doxorubicin in high grade soft tissue sarcoma: a randomized trial of the Scandinavian Sarcoma Group. J Clin Oncol, 1989, 7(10): 1504-1513.
9. Edmonson JH, Fleming TR, Ivins JC, et al. Randomized study of systemic chemotherapy following complete excision of nonoesseous sarcomas. J Clin Oncol, 1984, 2(12): 1390-1396.
10. Chang AE, Kinsella T, Glatstein E, et al. Adjuvant chemotherapy for patients with high-grade soft-tissue sarcomas of the extremity. J Clin Oncol, 1988, 6(9): 1491-1500.
11. Bramwell V, Rouesse J, Steward W, et al. 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. J Clin Oncol, 1994, 12(6): 1137-1149.
12. Lerner HJ, Amato DA, Savlov ED, et al. Eastern Cooperative Oncology Group: A comparison of adjuvant doxorubicin and observation for patients with localized soft-tissue sarcoma. J Clin Oncol, 1987, 5(4): 613-617.
13. Frustaci S, Gherlinzoni F, De Paoli A, et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: Results of the Italian randomized cooperative trial. J Clin Oncol, 2001, 19(5): 1238-1247.
14. Antman KH. Adjuvant therapy of sarcomas of soft tissue. Semin Oncol, 1997, 24: 556-560.
15. Benjamin RS. Evidence for using adjuvant chemotherapy as standard treatment of soft tissue sarcoma. Semin Radiat Oncol, 1999, 9(4): 349-351.
16. Cormier JN, Huang X, Xing Y, et al. Cohort analysis of patients with localized, high risk, extremity soft tissue sarcoma treated at two cancer centers: chemotherapy associated outcomes. J Clin Oncol, 2004, 22(22): 4567-4574.
17. Bramwell VHC. Controversies in Surgical Oncology: Routine anthracyclinebased adjuvant chemotherapy for stage III extremity soft tissue sarcoma. Ann Surg Oncol, 2007, 14: 1254-1256.
18. Verweij J, Sejnaeve C. The reason for confining the use of adjuvant chemotherapy in soft tissue sarcoma to the investigational setting. Semin Radiat Oncol, 1999, 9: 352-359.
19. Frustaci S, De Paoli A, Bidoli E, et al. Ifosfamide in the adjuvant therapy of soft tissue sarcomas. Oncology, 2003, 65(Suppl 2): 80-84.
20. Grobmyer SR, Maki RG, Demetri GD, et al. Neo-adjuvant chemotherapy for primary high-grade extremity soft tissue sarcoma. Ann Oncol, 2004, 15(11): 1667-1672.

Chinese Journal of Evidence-Based Medicine

Chemotherapy versus Non-Chemotherapy in the Treatment of Soft Tissue Sarcoma: A Systematic Review

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content