A study of clinical effects and prognosis factors on transarterial neoadjuvant chemotherapy of malignant ifbrous histiocytoma in soft tissues
GUO Jun
LI Ding-feng
LIU Shu-bin
CUI Qiu
LIU Cheng
Abstract：Objective To explore clinical effects in transarterial neoadjuvant chemotherapy of malignant ifbrous histiocytoma ( MFH ) in soft tissues,and to analyze the factors related to the prognosis of MFH in soft tissues.Methods From September 1999 to December 2011,clinical documents of 101 MFH in soft tissues patients treated by transarterial administration of Cisplatin ( CDDP ),Adriamycin ( AMD ) and Norcantharidin ( NTCD ) were reviewed.All the patients were divided into primary group ( group A,44 cases ) and recurrent group ( group B,57 cases ) and each group was further divided into 2 groups by treatment methods.Fifteen patients ( group A1 ) in group A received surgical resection,and the other 29 patients ( group A2 ) received simple transarterial neoadjuvant chemotherapy.Forty-ifve patients ( group B1 ) in group B received surgical resection and the other 12 patients ( group B2 ) received simple transarterial neoadjuvant chemotherapy.For patients in the operation groups,chemotherapy effects were determined from the tumor necrosis rate in the resected specimen.The 5-year relapse-free survival rate,the overall survival rate,recurrence and metastasis were observed.Nine factors that might affect prognosis such as age,sex,tumor size,tumor site,tumor inifltration depth,recurrence occurrence,pathological type,histological grade and histological response of chemotherapy were analyzed statistically.Results One hundred and one cases received follow-up.The average follow-up period was 60 months ( range: 3-145 months ).( 1 ) Twenty-three resected specimens were analyzed by tumor necrosis rate.4 / 5 cases ( 80.0％) in group A1 showed good chemotherapy response and the average tumor necrosis rate was 75.0％; 14 / 18 cases ( 77.8％) in group B1 showed good chemotherapy response and the average tumor necrosis rate was 73.8％; The differences between the two groups were not signiifcant.(P＞0.05 ).( 2 ) The 5-year relapse-free survival rate and the overall survival rate were 70.5％and 75.0％respectively in primary group,56.1％and 57.9％respectively in recurrent group.The differences of overall survival rate between the two groups were signiifcant (P＜0.05 ).( 3 ) Eighteen patients showed simple local recurrence ( 17.8％): 7 in group A ( 15.9％) and 11 in group B ( 19.3％).The average recurrence time was 14 months.Five patients ( 5.0％) showed simple distant metastasis: 1 in group A ( 2.3％) and 4 in group B ( 7.0％).The average metastasis time was 1 year ( range: 2-50 months ).Fifteen patients showed local recurrence accompanied by distant metastasis ( 14.9％).( 4 ) The age (P=0.03 ),tumor size (P=0.01 ),pelvic condition (P=0.02 ),recurrence occurrence (P=0.004 ),histological grade (P=0.01 ),histological response of chemotherapy (P=0.007 ) were related to 5-year overall survival rate.Multivariate analysis showed that major factors affecting prognosis were: pelvic condition (P=0.01 ),tumor size (P=0.002 ),histological grade (P=0.002 ),recurrence occurrence (P=0.0004 ),histological response of chemotherapy (P=0.008 ).( 5 ) The general condition was good and the major complication of chemotherapy was neutropenia ( 79％).Conclusions Transarterial neoadjuvant chemotherapy of CDDP,AMD and ( NTCD ) can signiifcantly increase the curative efifcacy of chemotherapy and survival rate in MFH treatment.Tumor site,tumor size,histological grade,recurrence occurrence,histological response of chemotherapy can affect the prognosis signiifcantly.
Keywords：Soft tissue neoplasmsChemoradiotherapyHistiocytomamalignant ifbrousPrognosis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 348-353 )