Standard therapy for soft-tissue sarcomas remains complete resection, irresectable tumours or tumours after resection with gross residual disease are a special challenge. For primary radiotherapy with median 60 Gy local control rates of 30–45% have been reported. We analysed retrospectively 11 cases of radiochemotherapy with single-agent Ifosfamide in patients with macroscopic soft-tissue sarcomas.

The patients were treated in irresectable high risk situations: T2-tumours (100%), G3 (73%), localisation at the trunk (82%). Radiation therapy was performed with median 60 Gy (50 to 72.6 Gy) in 1.8–2.0 Gy single fraction dose, once daily, five times a week. During the first and fifth week the concommittant chemotherapy with 1.0/1.5 gr/m2/d Ifosfamide on five days was added. Two patients received trimodal therapy with additional hyperthermia. The therapy was completed in 73% of the patients. Average local control time was 91 months, median disease-free-survival/overall-survival was 8/26 months. Five-year rates for local control/disease free survival/overall survival were 70%/34%/34%. Long-term tumor control could be achieved in three patients. The median disease free survival is dependant on the histological tumor grading (21 vs 8 months for G2 vs G3 tumors, no statistical significance due to small patient numbers). The limited prognosis is mainly caused by systemic treatment failure.

Concomitant radiochemotherapy with Ifosfamide in patients with macroscopic soft-tissue-sarcomas yields a good local control rate of 70% compared to previously published 30% in definitive radiotherapy with similar radiation doses. Additional simultaneous chemotherapy should be considered for irresectable soft tissue sarcomas or tumors after resection with gross residual disease, if the applicable radiation dose is limited due to close vicinity of organs at risk. A decrease of systemic failure with additional chemotherapy might be speculated.