| Peer-Reviewed

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

Received: 28 June 2014    Accepted: 21 July 2014    Published: 10 August 2014
Views:       Downloads:
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.

Published in Journal of Cancer Treatment and Research (Volume 2, Issue 4)
DOI 10.11648/j.jctr.20140204.11
Page(s) 33-36
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Single Agent Adriamycin, Soft Tissue Sarcomas, Outcome

References
[1] Mouridsen HT, Bastholt L, Somers R, Santoro A, Bramwell V, Mulder JH, et al. Adriamycin versus epirubicin in advanced soft tissue sarcomas. A randomized phase II/phase III study of the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer Clin Oncol. 1987 Oct;23(10):1477-83.
[2] Shinohara N, Yokoyama K. [Adjuvant chemotherapy of soft tissue sarcoma]. Gan To Kagaku Ryoho. 1990 Feb;17(2):198-204.
[3] African Pathologists' Summit Working G. Proceedings of the African Pathologists Summit; March 22-23, 2013; Dakar, Senegal: A Summary. Arch Pathol Lab Med. 2014 Jun 25.
[4] Eyesan SU, Obalum DC, Nnodu OE, Abdulkareem FB, Ladejobi AO. Challenges in the diagnosis and management of musculoskeletal tumours in Nigeria. Int Orthop. 2009 Feb;33(1):211-3.
[5] Fatusi OA, Ajike SO, Olateju SO, Adebayo AT, Gbolahan OO, Ogunmuyiwa SA. Clinico-epidemiological analysis of orofacial rhabdomyosarcoma in a Nigerian population. Int J Oral Maxillofac Surg. 2009 Mar;38(3):256-60.
[6] Chukwuanukwu TO, Anyanwu SN. Giant fibrosarcoma prostuberans of abodominal wall: management problems in resources-constrained country. Niger J Clin Pract. 2009 Sep;12(3):338-40.
[7] Stefan DC, Elzawawy AM, Khaled HM, Ntaganda F, Asiimwe A, Addai BW, et al. Developing cancer control plans in Africa: examples from five countries. Lancet Oncol. 2013 Apr;14(4):e189-95.
[8] Pfeffer MR, Sulkes A, Biran S. Treatment of advanced soft tissue sarcomas with a modified CYVADIC protocol. Oncology. 1984;41(5):308-13.
[9] Roseman JM. Effective management of extremity cancers using cisplatin and etoposide in isolated limb perfusions. J Surg Oncol. 1987 Jul;35(3):170-2.
[10] Borden EC, Amato DA, Edmonson JH, Ritch PS, Shiraki M. Randomized comparison of doxorubicin and vindesine to doxorubicin for patients with metastatic soft-tissue sarcomas. Cancer. 1990 Sep 1;66(5):862-7.
[11] Eggermont AM, Schraffordt Koops H, Lienard D, Kroon BB, van Geel AN, Hoekstra HJ, et al. Isolated limb perfusion with high-dose tumor necrosis factor-alpha in combination with interferon-gamma and melphalan for nonresectable extremity soft tissue sarcomas: a multicenter trial. J Clin Oncol. 1996 Oct;14(10):2653-65.
[12] Wilky BA, Meyer CF, Trent JC. Pazopanib in sarcomas: expanding the PALETTE. Curr Opin Oncol. 2013 Jul;25(4):373-8.
[13] Edmonson JH, Ryan LM, Blum RH, Brooks JS, Shiraki M, Frytak S, et al. Randomized comparison of doxorubicin alone versus ifosfamide plus doxorubicin or mitomycin, doxorubicin, and cisplatin against advanced soft tissue sarcomas. J Clin Oncol. 1993 Jul;11(7):1269-75.
[14] Budd GT. Palliative chemotherapy of adult soft tissue sarcomas. Semin Oncol. 1995 Apr;22(2 Suppl 3):30-4.
[15] Rouesse J, Spielmann M, Le Chevalier T, Tubiana-Hulin M, Tursz T. [Chemotherapy of soft tissue sarcoma in adults]. Bull Acad Natl Med. 1991 Nov;175(8):1251-9; discussion 9-60.
[16] Bramwell VH. Current perspectives in the management of soft-tissue sarcoma. The role of chemotherapy in multimodality therapy. Can J Surg. 1988 Nov;31(6):390-6.
[17] Bramwell VH, Anderson D, Charette ML. Doxorubicin-based chemotherapy for the palliative treatment of adult patients with locally advanced or metastatic soft-tissue sarcoma: a meta-analysis and clinical practice guideline. Sarcoma. 2000;4(3):103-1
[18] Conley AP, Trent J, Zhang W. Recent progress in the genomics of soft tissue sarcomas. Curr Opin Oncol. 2008 Jul;20(4):395-9.
[19] Clarkson P, Ferguson PC. Primary multidisciplinary management of extremity soft tissue sarcomas. Curr Treat Options Oncol. 2004 Dec;5(6):451-62.
[20] Dziegiel P, Salwa-Zurawska W, Zurawski J, Wojnar A, Zabel M. Prognostic significance of augmented metallothionein (MT) expression correlated with Ki-67 antigen expression in selected soft tissue sarcomas. Histol Histopathol. 2005 Jan;20(1):83-9.
[21] Campos M, SG DEC, Ribeiro GG, Eguchi FC, Silva SR, CZ DEO, et al. Ki-67 and CD100 immunohistochemical expression is associated with local recurrence and poor prognosis in soft tissue sarcomas, respectively. Oncol Lett. 2013 May;5(5):1527-35.
[22] Komdeur R, Klunder J, van der Graaf WT, van den Berg E, de Bont ES, Hoekstra HJ, et al. Multidrug resistance proteins in rhabdomyosarcomas: comparison between children and adults. Cancer. 2003 Apr 15;97(8):1999-2005.
[23] Stebbing J. Cancer: Where were we, where are we, where are we going. Med Leg J. 2014 Jun 9;82(2):57-66.
[24] Michielin O, Coukos G. [Genomics medicine and oncology]. Praxis (Bern 1994). 2014 May 7;103(10):591-6.
[25] Shiraki M, Enterline HT, Brooks JJ, Cooper NS, Hirschl S, Roth JA, et al. Pathologic analysis of advanced adult soft tissue sarcomas, bone sarcomas, and mesotheliomas. The Eastern Cooperative Oncology Group (ECOG) experience. Cancer. 1989 Jul 15;64(2):484-90.
[26] Changchien YC, Tatrai P, Papp G, Sapi J, Fonyad L, Szendroi M, et al. Poorly differentiated synovial sarcoma is associated with high expression of enhancer of zeste homologue 2 (EZH2). J Transl Med. 2012;10:216.
[27] Ogilvie CM, Crawford EA, Slotcavage RL, King JJ, Lackman RD, Hartner L, et al. Treatment of adult rhabdomyosarcoma. Am J Clin Oncol. 2010 Apr;33(2):128-31.
[28] Mandong BM, Kidmas AT, Manasseh AN, Echejoh GO, Tanko MN, Madaki AJ. Epidemiology of soft tissue sarcomas in Jos, North Central Nigeria. Niger J Med. 2007 Jul-Sep;16(3):246-9.
Cite This Article
  • APA Style

    Misauno M. A., Ode M.B., Shitta A.H., Nwadiaro H.C. (2014). Outcome of Chemotherapy for Adult Soft Tissue Sarcomas in Jos, North Central Nigeria. Journal of Cancer Treatment and Research, 2(4), 33-36. https://doi.org/10.11648/j.jctr.20140204.11

    Copy | Download

    ACS Style

    Misauno M. A.; Ode M.B.; Shitta A.H.; Nwadiaro H.C. Outcome of Chemotherapy for Adult Soft Tissue Sarcomas in Jos, North Central Nigeria. J. Cancer Treat. Res. 2014, 2(4), 33-36. doi: 10.11648/j.jctr.20140204.11

    Copy | Download

    AMA Style

    Misauno M. A., Ode M.B., Shitta A.H., Nwadiaro H.C. Outcome of Chemotherapy for Adult Soft Tissue Sarcomas in Jos, North Central Nigeria. J Cancer Treat Res. 2014;2(4):33-36. doi: 10.11648/j.jctr.20140204.11

    Copy | Download

  • @article{10.11648/j.jctr.20140204.11,
      author = {Misauno M. A. and Ode M.B. and Shitta A.H. and Nwadiaro H.C.},
      title = {Outcome of Chemotherapy for Adult Soft Tissue Sarcomas in Jos, North Central Nigeria},
      journal = {Journal of Cancer Treatment and Research},
      volume = {2},
      number = {4},
      pages = {33-36},
      doi = {10.11648/j.jctr.20140204.11},
      url = {https://doi.org/10.11648/j.jctr.20140204.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jctr.20140204.11},
      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.},
     year = {2014}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Outcome of Chemotherapy for Adult Soft Tissue Sarcomas in Jos, North Central Nigeria
    AU  - Misauno M. A.
    AU  - Ode M.B.
    AU  - Shitta A.H.
    AU  - Nwadiaro H.C.
    Y1  - 2014/08/10
    PY  - 2014
    N1  - https://doi.org/10.11648/j.jctr.20140204.11
    DO  - 10.11648/j.jctr.20140204.11
    T2  - Journal of Cancer Treatment and Research
    JF  - Journal of Cancer Treatment and Research
    JO  - Journal of Cancer Treatment and Research
    SP  - 33
    EP  - 36
    PB  - Science Publishing Group
    SN  - 2376-7790
    UR  - https://doi.org/10.11648/j.jctr.20140204.11
    AB  - 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.
    VL  - 2
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Department of Surgery, Jos University Teaching Hospital, P.M.B 2076, Plateau State Nigeria

  • Department of Orthopaedics and Traumatology, Jos University Teaching Hospital Jos, Plateau State Nigeria

  • Department of Surgery, Jos University Teaching Hospital, P.M.B 2076, Plateau State Nigeria

  • College of Medicine University of Abuja Teaching Hospital Gwagwalada Nigeria

  • Sections