Effect of anthracyclines/ifosfamide-based adjuvant chemotherapy for soft tissue sarcoma: a conventional and network Meta-analysis

J Chemother. 2021 Sep;33(5):319-327. doi: 10.1080/1120009X.2021.1873631. Epub 2021 Jan 27.

Abstract

The objective of this study is to assess the effect of anthracyclines/ifosfamide-based adjuvant chemotherapy for soft tissue sarcoma (STS) and provide a relative ranking of regimens for STS. We pooled the hazard ratios of overall survival (OS) and relapse free survival (RFS) by conventional meta-analysis to appraise whether adjuvant chemotherapy benefits STS and performed a network meta-analysis using a Bayesian model to establish the relative ranking of regimens. Nine studies were included in our meta-analysis. The pooled hazard ratios were 0.68 (95%CI: 0.53-0.86) and 0.65 (95%CI: 0.52-0.83) for OS and RFS, respectively. Doxorubicin was indicated as best regimen to benefit OS (probability: 30.2%), while cyclophosphamide + vincristine + doxorubicin + dactinomycin was indicated as the best regimen for RFS (probability: 37.1%). This meta-analysis confirms the positive effect of anthracyclines/ifosfamide-based adjuvant chemotherapy in STS for both OS and RFS.

Keywords: STS; Soft tissue sarcoma; anthracyclines/ifosfamide-based adjuvant chemotherapy; conventional meta-analysis; network meta-analysis.

Publication types

  • Meta-Analysis

MeSH terms

  • Anthracyclines / administration & dosage
  • Anthracyclines / adverse effects
  • Anthracyclines / therapeutic use*
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bayes Theorem
  • Chemotherapy, Adjuvant
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / adverse effects
  • Cyclophosphamide / therapeutic use
  • Dactinomycin / administration & dosage
  • Dactinomycin / adverse effects
  • Dactinomycin / therapeutic use
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Doxorubicin / therapeutic use
  • Humans
  • Ifosfamide / administration & dosage
  • Ifosfamide / adverse effects
  • Ifosfamide / therapeutic use*
  • Neoplasm Recurrence, Local
  • Network Meta-Analysis
  • Sarcoma / drug therapy*
  • Sarcoma / mortality
  • Survival Analysis
  • Vincristine / administration & dosage
  • Vincristine / adverse effects
  • Vincristine / therapeutic use

Substances

  • Anthracyclines
  • Antineoplastic Agents
  • Dactinomycin
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Ifosfamide

Supplementary concepts

  • VACA protocol