Outcome of Chemotherapy for Adult Soft Tissue Sarcomas in Jos, North Central Nigeria

Abstract

Background: Soft tissue sarcomas (STS) have a poor response to chemotherapy and reports have documented a 20% response rate. Chemotherapeutic regimens have evolved from the use of multiple drug combinations which were thought to be more efficacious, to high doses of single agent chemotherapy and targeted therapies. Predicting the response to chemotherapy in soft tissue sarcomas is difficult because even tumours of the same class exhibit different patterns of responsiveness to the same drugs. Single agent Adriamycin chemotherapy for soft tissue sarcomas is cheap and reputably gives comparable treatment outcomes to combination therapies. This study was therefore aimed at determining the outcome of management of soft tissue sarcomas with single agent Adriamycin chemotherapy. Patients and Method: This was a prospective analysis of consecutive patients managed for STS with single agent Adriamycin at the Jos University Teaching Hospital from January 2000 to December 2009.Results: A total of 89 adult soft tissue sarcomas were managed in 49 males and 40 females (M: F=1.2:1). The mean age of the study population was 37.4 +/- 12.6 with age range of 18 to 85years.Forty patients (44.9%) could afford chemotherapy with single agent Adriamycin and formed the basis of this study while 49 (53.1%) could not afford chemotherapy. All the tumours were more than 5cm in size at presentation. Rhabdomyosarcoma was seen in 17 patients (42.5%), fibrosarcoma in 14 (35%), liposarcoma and dermatofibrosarcoma 4 (10% ) each and one patient (2.5% ) had synovial sarcoma. Response to chemotherapy was seen in seven patients (17.5%) and this was noticed within six weeks of chemotherapy. Conclusion: Response to chemotherapy with single agent Adriamycin for the treatment of soft tissue sarcomas is very poor and it is difficult to predict which patient will respond to this therapy in our setting. We therefore suggest that all patients with STS on single agent Adriamycin in resource scarce settings should have their treatment discontinued or changed to other chemotherapeutic combinations if there is no response to chemotherapy after six weeks.