Treatment of vascular soft tissue sarcomas with razoxane, vindesine, and radiation.

Abstract

PURPOSE:

In previous studies, razoxane and vindesine together with radiotherapy was proved to be effective in soft tissue sarcomas (STS). Because razoxane leads to a redifferentiation of pathological tumor blood vessels, it was of particular interest to study the influence of this drug combination in vascular soft tissue sarcomas.

METHODS AND MATERIALS:

This open multicenter Phase II study was performed by the Austrian Society of Radiooncology. Among 13 evaluable patients (10 angiosarcomas and 3 hemangio-pericytomas), 9 had unresectable measurable disease, 3 showed microscopic residuals, and 1 had a resection with clear margins. They received a basic treatment with razoxane and vindesine supported by radiation therapy. Outcome measures were objective response rates, survival time, and the incidence of distant metastases.

RESULTS:

In nine patients with measurable vascular soft tissue sarcomas (eight angiosarcomas and one hemangiopericytoma), 6 complete remissions, 2 partial remissions, and 1 minor remission were achieved, corresponding to a major response rate of 89%. A maintenance therapy with razoxane and vindesine of 1 year or longer led to a suppression of distant metastases. The median survival time from the start of the treatment is 23+ months (range, 3-120+) for 12 patients with macroscopic and microscopic residual disease. The progression-free survival at 6 months was 75%. The combined treatment was associated with a low general toxicity, but attention must be given to increased normal tissue reactions.

CONCLUSIONS:

This trimodal treatment leads to excellent response rates, and it suppresses distant metastases when given as maintenance therapy.

• Authors: Walter Rhomberg, Anna Wink, Boris Pokrajac, Helmut Eiter, Arnulf Hackl, Brigitte Pakisch, Angela Ginestet, Peter Lukas, Richard Pötter
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 74 Issue 1 Pg. 187-91 (May 01 2009) ISSN: 1879-355X [Electronic] United States
• PMID: 19004568 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study)

Chemical References

• Radiation-Sensitizing Agents
• Razoxane
• Vindesine

Topics

• Aged
• Drug Administration Schedule
• Female
• Hemangiopericytoma (drug therapy, mortality, radiotherapy)
• Hemangiosarcoma (drug therapy, mortality, radiotherapy)
• Humans
• Male
• Middle Aged
• Radiation-Sensitizing Agents (therapeutic use)
• Radiotherapy Dosage
• Razoxane (administration & dosage)
• Vindesine (administration & dosage)