Abstract
Background. Pleomorphic sarcoma is an aggressive soft tissue sarcoma. In patients with high-risk extremity sarcomas, the significant survival benefits conferred by an intense regimen of neoadjuvant chemoradiotherapy and surgery were reported. To our knowledge, this is the first report in the literature of the neoadjuvant use of trabectedin in a patient with high-grade pleomorphic sarcoma, ineligible for standard neoadjuvant combination therapy with an anthracycline-based regimen. Case Presentation. Here we present a 58-year-old White male with a large tumor in the left thigh, but with no signs of metastases. Owing to the history of severe heart attack, three cycles of neoadjuvant trabectedin were administrated to achieve surgically wide margins. After two cycles, an 18F-FDG-PET showed a large proportion of the central tumor area was without metabolic activity. According to RECIST and Choi criteria, the tumor was stable. After the third cycle of trabectedin, the patient underwent a complete resection, which revealed completely necrotic high-grade pleomorphic sarcoma (stage pT2b), with only a small vital area. Conclusion. The present paper on a promising treatment with neoadjuvant trabectedin of patients with high-grade pleomorphic sarcoma might suggest that such treatment approach may provide a greater chance of cure and survival of such patients.
Highlights
Pleomorphic sarcoma is an aggressive so tissue sarcoma
Trabectedin was generally well tolerated and showed manageable toxicity when administered to patients with myxoid liposarcoma as neoadjuvant chemotherapy [3]
Staging was completed with a computerized tomography (CT) scan of the chest and abdomen and a uorine-18 uorodeoxyglucose (FDG)-positron emission tomography (PET) scan. is scan con rmed the presence of the mass and revealed an increased FDG uptake with a maximal standardized uptake value of 10.5 in the proximal region
Summary
E high-risk stage III so tissue sarcomas (STS) are a heterogeneous group of relatively rare mesenchymal neoplasms with important differences in chemosensitivity. e use of chemotherapy in the neoadjuvant and adjuvant settings in STS is controversial. Mullen and colleagues have reported the signi cant survival bene ts in patients with high-risk, extremity STS who received an intense regimen of neoadjuvant chemoradiotherapy with concomitant radiotherapy [1]. Trabectedin was generally well tolerated and showed manageable toxicity when administered to patients with myxoid liposarcoma as neoadjuvant chemotherapy [3] Based on these ndings, a neoadjuvant treatment strategy with trabectedin could be extremely bene cial for those patients, especially those who are not eligible for an aggressive combination therapy. We present the results of the neoadjuvant use of trabectedin in a patient with high-grade pleomorphic sarcoma, ineligible for standard neoadjuvant combination therapy with an anthracycline-based regimen
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
