Abstract
One way to enhance quality of life for patients with metastatic sarcoma is to maximize time off chemotherapy—a chemotherapy-free interval. While image-guided ablation of sarcoma metastases may reduce the need for chemotherapy, it remains unknown how long ablation could extend the chemotherapy-free interval. The purpose of our study was to determine the chemotherapy-free interval in comparison to overall survival and progression-free survival in sarcoma patients who undergo ablation procedures. An IRB-approved, single institution, HIPAA compliant database was queried for sarcoma patients who underwent image-guided ablation procedures between 2007 and 2018. Patient demographics, histologic subtype, and other clinical characteristics were recorded. Kaplan-Meier analysis was performed to compute median overall survival, median progression-free survival (local and distant), and the median chemotherapy-free interval (systemic and cytotoxic) after ablation. Univariate and multivariate analyses were performed using the log-rank test and Cox proportional-hazards model, respectively. A total of 100 sarcoma patients were included in the analysis. The most common histologic subtype was leiomyosarcoma (38%). Median overall survival after ablation of sarcoma metastases was 52.4 months (95% CI: 46.9–64.0 months). The median systemic chemotherapy-free interval following ablation of sarcoma metastases was 14.7 months (95% CI: 8.6–34.3 months). The median cytotoxic chemotherapy-free interval following ablation of sarcoma metastases was 81.3 months (95% CI: 34.3-median not reached). In conclusion, ablation of sarcoma metastases can provide an extended systemic chemotherapy-free interval of greater than 1 year. Ablation of sarcoma metastases may improve patient quality of life by extending the chemotherapy-free interval.
Highlights
Most sarcoma patients are diagnosed with localized disease, which can often be cured through a combination of surgery and radiation therapy
A total of 100 sarcoma patients were included in the analysis
Median overall survival was 52.4 months after ablation of sarcoma metastases
Summary
Most sarcoma patients are diagnosed with localized disease, which can often be cured through a combination of surgery and radiation therapy. While chemotherapy has traditionally been used for patients with metastatic sarcoma, classical regimens typically do not provide a survival benefit [6]. These agents are associated with adverse effects, such as cardiomyopathy (doxorubicin) and vascular toxicity (gemcitabine) [7, 8]. In cancer patients who cannot be cured, treatment should focus on creating both increased quantity and quality of life [9]. One strategy to enhance quality of life for patients with incurable cancer is to maximize time without toxic effects, which can be achieved by providing time off chemotherapy—a chemotherapy-free interval [10]
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