Complex approach in the treatment of retroperitoneal fibrosarcoma.

Abstract

e22537 Background: to improve the efficiency of the treatment of retroperitoneal fibrosarcomas by developing complex approach with using neoadjuvant endoarterial chemotherapy, surgical intervention followed by radiotherapy. Methods: For material of the study we analyzed treatment results of 34 patients with retroperitoneal giant fibrosarcoma. Depending on the method of treatment patients were divided into 2 groups: 1 main group n = 16, underwent neoadjuvant chemotherapy + surgery + radiotherapy 2 control group n = 18 who underwent surgery + adjuvant chemotherapy. There was performed endoarterial catheter into the close blood vessels feeding the tumor at the preoperative period. Chemotherapy was conducted 3 cycles by CAP regimen. Drugs were administered endoarterially with 48 hours infusion. After receiving chemotherapy for all patients there was performed radical surgery. Postoperatively patients received radiotherapy to the tumor bed with single dose 1.8-2 Gr and up to total dose - 60 Gr. Results: Therewere selected the following criteria: - The effect of chemotherapy on tumor size, extension and traumatizing of surgical treatment, and the duration of relapse-free and metastases-free period. - The effectiveness of postoperative radiotherapy for the duration of disease-free period. Chemotherapy in the preoperative period, led to partial regression of tumors in 9 (58.3%) patients. In 4 (25.0%) patients the process was stabilized, in 3 (16.7% 5 + 15%) observed progression of the process. Study of patients’ survival, which is the main determining factor showed an increase of survival in the main group up to 18.2 +0.4 months, and in the control group 12.4 +0.3 months. (P < 0.05). Recurrence free survival in the main group was 10,2 +0,4 months, and in the control group 7,3 +0,3months (P < 0.05), metastases-free survival consisted 11,4+0,5 months and 9,1+0,4 month, respectively.(P < 0.05). Conclusions: Complex approach in the treatment of retroperitoneal fibrosarcomas significantly increased the overall survival and as well as the relapse-free and metastases-free survival. Using adjuvant continuously endoarterial chemotherapy gives partial effect in 58.3% cases, and thereby leads to more favorable conditions for surgery.