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

This study has been completed.
NCIC Clinical Trials Group
Information provided by (Responsible Party):
European Organisation for Research and Treatment of Cancer - EORTC Identifier:
First received: November 1, 1999
Last updated: August 7, 2014
Last verified: July 2002

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 Intervention Phase
Endometrial Cancer
Kidney Cancer
Ovarian Cancer
Biological: filgrastim
Drug: doxorubicin hydrochloride
Drug: ifosfamide
Drug: isolated perfusion
Procedure: adjuvant therapy
Procedure: conventional surgery
Radiation: radiation therapy
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Primary Purpose: Treatment

Resource links provided by NLM:

Further study details as provided by European Organisation for Research and Treatment of Cancer - EORTC:

Estimated Enrollment: 350
Study Start Date: February 1995
Study Completion Date: June 2012
Primary Completion Date: February 2006 (Final data collection date for primary outcome measure)
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.


Ages Eligible for Study:   16 Years to 69 Years
Genders Eligible for Study:   Both
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
  Contacts and Locations
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Please refer to this study by its identifier: NCT00002641

  Show 45 Study Locations
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
  More Information

Additional Information:
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.

Additional 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, EORTC-62931, CAN-NCIC-SR3
Study First Received: November 1, 1999
Last Updated: August 7, 2014
Health Authority: United States: Federal Government

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:
Neoplasms by Histologic Type
Neoplasms, Connective and Soft Tissue
Neoplasms, Germ Cell and Embryonal
Neoplasms, Nerve Tissue
Neuroectodermal Tumors
Neuroendocrine Tumors
Isophosphamide mustard
Liposomal doxorubicin
Alkylating Agents
Antibiotics, Antineoplastic
Antineoplastic Agents
Antineoplastic Agents, Alkylating
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Therapeutic Uses
Topoisomerase II Inhibitors
Topoisomerase Inhibitors processed this record on October 13, 2015