Some advanced soft tissue sarcoma (STS) patients are highly responsive to combination chemotherapy, though combination chemotherapy for advanced STS has not proved to be superior to single-agent chemotherapy except for particular subtypes such as Ewing sarcoma. We tried to identify predictive factors for response to combination chemotherapy.Patients and methods
We retrospectively reviewed advanced STS patients treated with CYVADIC chemotherapy between October 2005 and June 2011 in the Cancer Institute Hospital of JFCR. CYVADIC consists of cyclophosphamide (d2, 500 mg/m2), vincristine (d1, 1.5 mg/m2/day, max 2.0 mg/body), doxorubicin (d 1, 50 mg/m2), and dacarbazine (d1-5, 250 mg/m2). Objective response and prognosis were evaluated and statistical analysis was used for exploring predictive factors related to response and survival.Results
Twenty-nine patients were included in the current study and median follow-up time was 17.1 months. Morphologic features of pathological specimens were as follows; 18 spindle cell sarcomas, 6 pleomorphic sarcomas, 2 myxoid sarcomas, 1 neuroblastoma and 1 sarcoma with rhabdoid features. Median age was 51 year old. Response rate was 31 %, median PFS was 7.4 months and median OS from CYVADIC induction was 16.9 months. There were no therapy-related deaths, but three patients needed a dose reduction due to adverse events. Median treatment cycles were 6. Eleven patients failed to continue six cycles because of progression and number of involved organs (>3) was the significant predictive factor by multivariate analysis. On the other hand, 12 patients had objective response or PFS longer than 1 year and number of involved organs (<2) and ALP within normal limits were the significant predictive factor.Conclusion
Response of CYVADIC for advanced STS is moderate and number of involved organs is the predictive factor to response to CYVADIC.