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Combination Chemotherapy With or Without Hyperthermia Therapy in Treating Patients With Soft Tissue Sarcoma

This study has been completed.
The European Society for Hyperthermic Oncology
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: November 1, 1999
Last updated: September 16, 2013
Last verified: November 2006

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Hyperthermia therapy kills tumor cells by heating them to several degrees above body temperature. It is not known whether receiving chemotherapy plus hyperthermia is more effective than receiving chemotherapy alone in treating patients with soft tissue sarcoma.

PURPOSE: This randomized phase III trial is studying combination chemotherapy alone to see how well it works compared to combination chemotherapy and hyperthermia therapy in treating patients with soft tissue sarcoma.

Condition Intervention Phase
Drug: doxorubicin hydrochloride
Drug: etoposide
Drug: ifosfamide
Procedure: conventional surgery
Procedure: hyperthermia treatment
Radiation: radiation therapy
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Primary Purpose: Treatment
Official Title: Randomized Study Comparing Neoadjuvant Chemotherapy Etoposide + Ifosfamide + Adriamycin (EIA) Combined With Regional Hyperthermia (RHT) Versus Neoadjuvant Chemotherapy Alone in the Treatment of High-Risk Soft Tissue Sarcomas in Adults

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Local progression-free survival

Secondary Outcome Measures:
  • Response as assessed by WHO criteria
  • Overall survival
  • Relapse-free survival
  • Acute and late complications as assessed by CTC v 1.0

Estimated Enrollment: 340
Study Start Date: July 1997
Study Completion Date: June 2010
Detailed Description:


  • Determine local progression-free survival of patients with high-risk soft tissue sarcoma treated with neoadjuvant etoposide, ifosfamide, and doxorubicin with or without regional hyperthermia.
  • Determine the tumor response rate, local disease control rate, and overall survival in patients treated with this regimen.

OUTLINE: This is a randomized study. Patients are stratified according to high-risk category (S1 vs S2 vs S3) and disease site (extremity vs nonextremity). Patients are randomized to one of two treatment arms.

  • Arm I: Patients receive etoposide IV over 30 minutes on days 1 and 4, ifosfamide IV over 60 minutes on days 1-4, and doxorubicin IV over 30 minutes on day 1. Treatment continues every 21 days for a total of 4 courses. Patients also undergo regional hyperthermia.
  • Arm II: Patients receive chemotherapy alone as in arm I. Patients in both arms undergo definitive surgery 4-6 weeks after chemotherapy. Patients also undergo radiotherapy beginning 4-6 weeks after surgery. After completion of surgery and radiotherapy, patients with non-resectable tumors showing no disease progression receive an additional 4 courses of chemotherapy with or without regional hyperthermia according to above treatment schedule.

Patients are followed every 3 months for 1 year, every 4 months for 2 years, and then every 6 months thereafter.

PROJECTED ACCRUAL: A total of 340 patients (170 patients per arm) will be accrued for this study within 3.5 years.


Ages Eligible for Study:   18 Years to 70 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically proven grade II or III soft tissue sarcoma of one of following high-risk groups:

    • Grade II/III primary tumor with lesion size of at least 5 cm, deep, and extracompartmental (S1)
    • Local recurrence of primary tumor (S2)
    • Inadequate surgical excision of S1 or S2 (S3)
  • Disease recurrence after prior surgery allowed
  • The following histological types are eligible:

    • Malignant fibrous histiocytoma
    • Liposarcoma (round cell and pleomorphic)
    • Leiomyosarcoma
    • Fibrosarcoma
    • Rhabdomyosarcoma
    • Synovial sarcoma
    • Malignant paraganglioma
    • Neurofibrosarcoma (malignant schwannoma)
    • Extraskeletal Ewing's sarcoma
    • Extraskeletal osteosarcoma
    • Malignant peripheral neuroectodermal tumors
    • Mesenchymal chondrosarcoma
    • Angiosarcoma
    • Miscellaneous sarcoma
    • Unclassified sarcoma
  • No distant metastases



  • 18 to 70

Performance status:

  • WHO 0-2 OR
  • Karnofsky 60-100%

Life expectancy:

  • Not specified


  • WBC at least 3,500/mm^3
  • Platelet count at least 100,000/mm^3
  • No bleeding disorder


  • Bilirubin less than 1.25 times upper limit of normal
  • No severe hepatic dysfunction


  • Creatinine clearance greater than 60 mL/min
  • No chronic renal failure


  • No documented existing cardiac failure
  • No manifest heart failure (New York Heart Association class III or IV)
  • Left ventricular ejection fraction no more than 10% below institutional normal


  • No other prior or concurrent malignancy except adequately treated basal cell skin cancer or carcinoma in situ of the cervix
  • No other severe disease
  • No severe cerebrovascular disease
  • No extremely obese patients
  • No prior metallic implants relevant to the regional hyperthermia field
  • Not pregnant or nursing


Biologic therapy:

  • Not specified


  • No prior chemotherapy

Endocrine therapy:

  • Not specified


  • No prior radiotherapy (except to disease recurrence outside study irradiation field)


  • See Disease Characteristics
  • No prior mutilative surgery
  Contacts and Locations
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Please refer to this study by its identifier: NCT00003052

Robert Roessle Comprehensive Cancer Center at University of Berlin - Charite Campus Buch
Berlin, Germany, D-13122
Universitaetsklinikum Essen
Essen, Germany, D-45122
Universitaetsklinikum Hamburg-Eppendorf
Hamburg, Germany, D-20246
Klinikum der Universitaet Muenchen - Grosshadern Campus
Munich, Germany, D-81377
Sponsors and Collaborators
European Organisation for Research and Treatment of Cancer - EORTC
The European Society for Hyperthermic Oncology
OverallOfficial: Rolf D. Issels, MD, PhD Klinikum der Universitaet Muenchen - Grosshadern Campus
Study Chair: Rolf D. Issels, MD, PhD Klinikum der Universitaet Muenchen - Grosshadern Campus
  More Information

Issels RD, Lindner LH, Wust P, et al.: Regional hyperthermia (RHT) improves response and survival when combined with systemic chemotherapy in the management of locally advanced, high grade soft tissue sarcomas (STS) of the extremities, the body wall and the abdomen: a phase III randomised pros. [Abstract] J Clin Oncol 25 (Suppl 18): A-10009, 547s, 2007.
Lindner LH, Schlemmer M, Hohenberger P, et al.: Risk assessment of early progression among 213 pts with high-risk soft tissue sarcomas (HR-STS) treated with neoadjuvant chemotherapy regional hyperthermia: EORTC 62961/ESHO-RHT 95 intergroup phase III study. [Abstract] J Clin Oncol 23 (Suppl 16): A-9020, 821s, 2005.

Publications automatically indexed to this study by Identifier (NCT Number): Identifier: NCT00003052     History of Changes
Other Study ID Numbers: CDR0000065699
Study First Received: November 1, 1999
Last Updated: September 16, 2013

Keywords provided by National Cancer Institute (NCI):
adult angiosarcoma
adult fibrosarcoma
adult leiomyosarcoma
adult liposarcoma
adult neurofibrosarcoma
adult synovial sarcoma
stage III adult soft tissue sarcoma
recurrent adult soft tissue sarcoma
adult extraskeletal osteosarcoma
adult malignant fibrous histiocytoma
adult rhabdomyosarcoma
stage I adult soft tissue sarcoma
stage II adult soft tissue sarcoma

Additional relevant MeSH terms:
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Body Temperature Changes
Signs and Symptoms
Liposomal doxorubicin
Etoposide phosphate
Isophosphamide mustard
Antibiotics, Antineoplastic
Antineoplastic Agents
Topoisomerase II Inhibitors
Topoisomerase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents, Phytogenic
Antineoplastic Agents, Alkylating
Alkylating Agents processed this record on April 28, 2017