Cem MİRİLİ, SEMRA PAYDAŞ, Mahmut BÜYÜKŞİMŞEK, Mert TOHUMCUOĞLU, Abdullah Evren YETİŞİR, Ali OĞUL

LONG-TERM OUTCOME OF SOFT TISSUE SARCOMAS TREATED WITH MESNA-DOXORUBICIN-IFOSFAMID-DACARBAZINE REGIMEN (MAID): A RETROSPECTIVE STUDY FROM A SINGE INSTITUTION

Aim:Soft tissue sarcomas (STSs) account for 1% of cancers in the adult population. The treatment of choice is surgery but chemotherapy and/or radiotherapy are frequently used due to aggressive cancer behavior or incomplete surgery. Doxorubicin- based regimens are the most frequently used chemotherapy combinations but real-life data about the efficacy and safety of these agents in our country is limited. We aimed to present clinicodemographic and prognostic features of STS cases treated with mesna, doxorubicin, ifosfamide, dacarbazine (MAID regimen). Materials and Methods:A total of forty-five STS cases who were diagnosed between 2007-2016 and treated with the MAID regimen as the initial therapy in Cukurova University were analyzed retrospectively. Associations between clinicodemographic parameters with overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier curves and with the log- rank test. Univariate-multivariate analyses were used to assess the prognostic values of parameters for OS-PFS. Results:The median age of the patients was 49 and the most common STS subtypes were undifferentiated pleomorphic carcinoma (37.8%) followed by liposarcoma (17.8%) and leiomyosarcoma (13.3%). According to the AJCC TNM stages, 15.6% stage 1-2, 53.3% stage 3, and 31.1% stage 4 disease. The median PFS/OS were 17/39 months, respectively. The 5-year PFS/OS rates were 14%/32.5%, respectively. In univariate analyses, mitosis, necrosis, stage, and surgery were both prognostic for PFS-OS. However, in multivariate analysis, only stage was an independent prognostic factor both for PFS-OS. Conclusion:Stage was the only independent prognostic factor for both PFS-OS in patients with STS who received the MAID chemotherapy as initial therapy.

Mesna-Doxorubisin-İfosfamid-Dakarbazin (MAID) ile Tedavi Edilen Yumuşak Doku Sarkom Hastalarimizin Uzun Dönem Takip Sonuçları: Tek Merkez Deneyimi

Amaç:Yumuşak doku sarkomları (STS) erişkin kanserlerin %1 ini oluşturan agresif kanserlerdendir. Temel tedavisi cerrahi rezeksiyon olmakla beraber kemoterapi ve radyoterapide uygun hastalarda kullanılmaktadır. Doxorubisin temelli tedaviler en sık kullanılan kemoterapi rejimleridir ancak bu rejimlerle ilgili gerçek hayat verisi ülkemizde çok azdır. Bizde bu sebeple mesna- doxorubisin-ifosfamid-dakarbazin içeren MAID rejimi başlangıç tedavisi olarak alan STS olgularımızın yaşam sürelerini tespit etmek ve prognostik olabilecek klinikodemografik özellikleri ortaya çıkarmakistedik. Materyal ve Metot:Çukurova Üniversitesi Tıp Fakültesi Tıbbi Onkoloji Anabilim Dalı'nda 2007-2016 yılları arasında Yumuşak doku sarkomu tanısı alan ve başlangıç tedavisi olarak MAID rejimi uygulanan 45 hasta retrospektif olarak çalışmaya dahil edildi. Genel sağkalım (OS) ve progresyonsuz sağkalım (PFS) ile klinikopatolojik parametreler arasındaki ilişkiler Kaplan-Meier eğrileri kullanılarak analiz edildi ve log-rank testi ile karşılaştırıldı. Tek değişkenli ve çok değişkenli analiz PFS ve OS için prognostik faktörleri tespit etmek amacıylakullanılmıştır. Bulgular:Median yaş 49 olup en sık görülen alt tip andiferansiye pleomorfik karsinom (%37,8) ardından liposarkom (%17,8), leiomyosarkom (%13,3) gelmektedir. Hastaların %15,6’sı evre 1-2, %53,3’ü evre 3 ve %31,1’i evre 4’tü. Median PFS ve OS 17 ay ve 39 ay olup 5 yıllık PFS ve OS oranları %14 ve %32,5 dur. Yaş, cinsyet ve grade in prognostik önemi saptanmamış olup univariate analizlere göre mitoz, nekroz, AJCC TNM evresi ve cerrahi hem PFS hem de OS için prognostiktir. Bununla beraber multivariate analizlere göre sadece AJCC TNM evresi hem PFS hem de OS için bağımsız prognostikfaktördür. Sonuç:Başlangıç tedavisi olarak MAID kemoterapisi alan olgularda PFS ve OS için tek bağımsız prognostik faktör AJCC TNMevredir.

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