Surgery With or Without Chemotherapy in Treating Patients With Soft Tissue Sarcoma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00002641
Recruitment Status : Completed
First Posted : January 27, 2003
Last Update Posted : August 8, 2014
NCIC Clinical Trials Group
Information provided by (Responsible Party):
European Organisation for Research and Treatment of Cancer - EORTC

Brief Summary:

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. It is not yet known whether giving chemotherapy after surgery is more effective than surgery alone in treating soft tissue sarcoma.

PURPOSE: Randomized phase III trial to compare the effectiveness of surgery with or without chemotherapy in treating patients who have soft tissue sarcoma.

Condition or disease Intervention/treatment Phase
Endometrial Cancer Kidney Cancer Ovarian Cancer Pheochromocytoma Sarcoma Biological: filgrastim Drug: doxorubicin hydrochloride Drug: ifosfamide Drug: isolated perfusion Procedure: adjuvant therapy Procedure: conventional surgery Radiation: radiation therapy Phase 3

Detailed Description:


  • Compare the local disease control, overall survival, and relapse-free survival in patients with high-grade soft tissue sarcoma treated with adjuvant high-dose doxorubicin and ifosfamide plus filgrastim (G-CSF) vs no adjuvant chemotherapy and G-CSF after definitive surgery.
  • Compare the toxicity and morbidity of these regimens in these patients.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to center, site of primary tumor (extremity vs trunk, including shoulder, pelvic girdle, head, or neck vs central, including intrathoracic, visceral, uterine, or retroperitoneal), size of primary tumor (less than 5 cm vs 5 cm or greater in largest diameter), postoperative radiotherapy (yes vs no), and isolated limb perfusion therapy (yes vs no).

Some patients undergo isolated limb perfusion therapy with cytotoxics and/or cytokines.

No more than 8 weeks after biopsy or inadequate surgery, patients undergo definitive surgery. Patients with complete resection undergo radiotherapy assessment and then randomization. Patients with incomplete or marginal resection (except for central lesions) undergo re-excision and, in the absence of macroscopic disease, assessment for postoperative radiotherapy followed by randomization.

  • Randomization: Patients are randomized to 1 of 2 treatment arms.

    • Arm I: Patients receive no adjuvant chemotherapy or filgrastim (G-CSF). Beginning within 6 weeks after surgery, eligible patients undergo radiotherapy as outlined below.
    • Arm II: Beginning within 4 weeks after surgery, patients receive high-dose doxorubicin IV over 20 minutes followed by ifosfamide IV over 24 hours and G-CSF subcutaneously daily beginning 24 hours after completion of ifosfamide infusion and continuing for 10 days. Treatment continues every 3 weeks for 5 courses. Beginning within 6 weeks after completion of chemotherapy, eligible patients undergo radiotherapy as outlined below.
  • Radiotherapy: Patients with incomplete or marginal resection undergo radiotherapy 5 days a week for 6-6.6 weeks. Patients with complete microscopic resection undergo radiotherapy 5 days a week for 5 weeks followed by boost radiotherapy 5 days a week for 1 week.

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

PROJECTED ACCRUAL: A total of 350 patients will be accrued for this study within 3.5 years.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 350 participants
Allocation: Randomized
Primary Purpose: Treatment
Study Start Date : February 1995
Actual Primary Completion Date : February 2006
Actual Study Completion Date : June 2012

Information from the National Library of Medicine

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Ages Eligible for Study:   16 Years to 69 Years   (Child, Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically proven soft tissue sarcoma that is amenable to definitive surgery no more than 8 weeks after biopsy or inadequate surgery

    • Eligible subtypes:

      • Alveolar soft part sarcoma
      • Angiosarcoma
      • Fibrosarcoma
      • Leiomyosarcoma
      • Malignant fibrous histiocytoma
      • Liposarcoma (round cell and pleomorphic)
      • Miscellaneous sarcoma (including pelvic mixed mesodermal tumors)
      • Malignant paraganglioma
      • Neurogenic sarcoma
      • Rhabdomyosarcoma
      • Synovial sarcoma
      • Unclassifiable sarcoma
    • Ineligible subtypes:

      • Chondrosarcoma
      • Dermatofibrosarcoma
      • Embryonal rhabdomyosarcoma
      • Ewing's sarcoma
      • Kaposi's sarcoma
      • Liposarcoma (myxoid and well differentiated)
      • Malignant mesothelioma
      • Neuroblastoma
      • Osteosarcoma
  • Confirmed high-grade tumor (i.e., Trojani Grade II or III)
  • No metastases on staging with chest x-ray and thoracic CT scan
  • No regional lymph node involvement
  • Locally recurrent disease allowed

    • Interval of 3 months or more between definitive surgery and recurrence



  • 16 to 69

Performance status:

  • WHO 0-1

Life expectancy:

  • Not specified


  • WBC greater than 4,000/mm^3
  • Platelet count greater than 120,000/mm^3
  • No bleeding disorders


  • Bilirubin no greater than 1.25 times normal
  • No severe hepatic dysfunction


  • Creatinine less than 1.6 mg/dL OR
  • Creatinine clearance greater than 60 mL/min


  • No clear history of angina
  • No documented myocardial infarction
  • No existing cardiac failure


  • No serious infection
  • No other malignancy except adequately treated carcinoma in situ of the cervix or basal cell or squamous cell skin cancer


Biologic therapy:

  • Not specified


  • No prior systemic chemotherapy

Endocrine therapy:

  • Not specified


  • No prior radiotherapy to affected area


  • See Disease Characteristics

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00002641

  Hide Study Locations
Karl-Franzens-University Graz
Graz, Austria, A-8010
Institut Jules Bordet
Brussels, Belgium, 1000
Hopital Universitaire Erasme
Brussels, Belgium, 1070
Cliniques Universitaires Saint-Luc
Brussels, Belgium, 1200
Universitair Ziekenhuis Antwerpen
Edegem, Belgium, B-2650
U.Z. Gasthuisberg
Leuven, Belgium, B-3000
Canada, Alberta
Tom Baker Cancer Center - Calgary
Calgary, Alberta, Canada, T2N 4N2
Cross Cancer Institute
Edmonton, Alberta, Canada, T6G 1Z2
Canada, British Columbia
British Columbia Cancer Agency - Vancouver Island Cancer Centre
Victoria, British Columbia, Canada, V8R 6V5
Canada, Manitoba
CancerCare Manitoba
Winnipeg, Manitoba, Canada, R3E 0V9
Canada, New Brunswick
Saint John Regional Hospital
Saint John, New Brunswick, Canada, E2L 4L2
Canada, Ontario
Cancer Care Ontario-Hamilton Regional Cancer Centre
Hamilton, Ontario, Canada, L8V 5C2
Cancer Care Ontario-London Regional Cancer Centre
London, Ontario, Canada, N6A 4L6
Ottawa Regional Cancer Centre
Ottawa, Ontario, Canada, K1H 1C4
Mount Sinai Hospital - Toronto
Toronto, Ontario, Canada, M5G 1X5
Canada, Quebec
Maisonneuve-Rosemont Hospital
Montreal, Quebec, Canada, H1T 2M4
McGill University
Montreal, Quebec, Canada, H2W 1S6
Aarhus Kommunehospital
Aarhus, Denmark, DK-8000
Copenhagen, Denmark, 2100
Centre Leon Berard
Lyon, France, 69373
CHU de la Timone
Marseille, France, 13385
Institut Gustave Roussy
Villejuif, France, F-94805
Robert Roessle Klinik
Berlin, Germany, D-13122
Universitaetsklinikum Essen
Essen, Germany, D-45122
Universitaets-Krankenhaus Eppendorf
Hamburg, Germany, D-20246
Klinikum Grosshadern
Munich, Germany, D-81377
Eberhard Karls Universitaet
Tuebingen, Germany, D-72076
Istituto Nazionale per lo Studio e la Cura dei Tumori
Milano (Milan), Italy, 20133
Antoni van Leeuwenhoek Hospital
Amsterdam, Netherlands, 1066 CX
Academisch Ziekenhuis Groningen
Groningen, Netherlands, 9713 EZ
Daniel Den Hoed Cancer Center at Erasmus University Medical Center
Rotterdam, Netherlands, 3075 EA
Instituto Portugues de Oncologia de Francisco Gentil - Centro de Lisboa
Lisbon, Portugal, 1099-023 Codex
National Cancer Institute - Bratislava
Bratislava, Slovakia, 833 10
Hospital de la Santa Cruz I Sant Pau
Barcelona, Spain, 08025
Inselspital, Bern
Bern, Switzerland, CH-3010
Centre Hospitalier Universitaire Vaudois
Lausanne, Switzerland, CH-1011
Kantonsspital - St. Gallen
St. Gallen, Switzerland, CH-9007
United Kingdom
Royal Devon and Exeter Hospital
Exeter, England, United Kingdom, EX2 5DW
St. James's Hospital
Leeds, England, United Kingdom, LS9 7TF
Royal Marsden NHS Trust - London
London, England, United Kingdom, SW3 6JJ
Middlesex Hospital- Meyerstein Institute
London, England, United Kingdom, WIT 3AA
Christie Hospital N.H.S. Trust
Manchester, England, United Kingdom, M20 4BX
Newcastle General Hospital
Newcastle Upon Tyne, England, United Kingdom, NE4 6BE
Nottingham City Hospital NHS Trust
Nottingham, England, United Kingdom, NG5 1PB
Weston Park Hospital
Sheffield, England, United Kingdom, S1O 2SJ
Sponsors and Collaborators
European Organisation for Research and Treatment of Cancer - EORTC
NCIC Clinical Trials Group
Study Chair: Penella J. Woll, MD, PhD Cancer Research Centre at Weston Park Hospital
Study Chair: Vivien H.C. Bramwell, MB, BS, PhD, FRCP Tom Baker Cancer Centre - Calgary

Le Cesne A, Van Glabbeke M, Woll PJ, et al.: The end of adjuvant chemotherapy (adCT) era with doxorubicin-based regimen in resected high-grade soft tissue sarcoma (STS): pooled analysis of the two STBSG-EORTC phase III clinical trials. [Abstract] J Clin Oncol 26 (Suppl 15): A-10525, 2008.

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: European Organisation for Research and Treatment of Cancer - EORTC Identifier: NCT00002641     History of Changes
Other Study ID Numbers: EORTC-62931
First Posted: January 27, 2003    Key Record Dates
Last Update Posted: August 8, 2014
Last Verified: July 2002

Keywords provided by European Organisation for Research and Treatment of Cancer - EORTC:
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 alveolar soft-part sarcoma
adult epithelioid sarcoma
adult malignant fibrous histiocytoma
adult malignant hemangiopericytoma
adult malignant mesenchymoma
adult rhabdomyosarcoma
localized benign pheochromocytoma
regional pheochromocytoma
recurrent pheochromocytoma
stage II uterine sarcoma
stage III uterine sarcoma
recurrent uterine sarcoma
uterine carcinosarcoma
uterine leiomyosarcoma
endometrial stromal sarcoma
ovarian sarcoma
clear cell sarcoma of the kidney
stage II adult soft tissue sarcoma

Additional relevant MeSH terms:
Endometrial Neoplasms
Kidney Neoplasms
Carcinoma, Renal Cell
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Uterine Neoplasms
Genital Neoplasms, Female
Urogenital Neoplasms
Neoplasms by Site
Uterine Diseases
Genital Diseases, Female
Urologic Neoplasms
Kidney Diseases
Urologic Diseases
Neoplasms, Glandular and Epithelial
Neuroendocrine Tumors
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Liposomal doxorubicin
Isophosphamide mustard
Antibiotics, Antineoplastic