ArticleBMC cancer2020
High cumulative doxorubicin dose for advanced soft tissue sarcoma.
Article in BMC cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 38 citations in OpenAlex.
- Hyaluronic acid-RSC pharmaceutics · 2026Article
- Cardiotoxicity, survival, and dexrazoxane use in patients with soft tissue sarcoma: a Danish population‑based cohort study.Acta oncologica (Stockholm, Sweden) · 2026Article
- Trajectory and Determinants of Left Ventricular Dysfunction Following Anthracycline-Based Therapy Among Breast Cancer Patients: A Three-Year Cohort Analysis in Indonesia.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Early anthracycline cardiotoxicity in adolescents and young adults with sarcoma: a prospective echocardiographic study.ESC heart failure · 2026Article
- Sarcoma: Cardiovascular and Oncologic Considerations: JACC: CardioOncology State-of-the-Art Review.JACC. CardioOncology · 2025Review
- Association of early dexrazoxane with reduced cardiotoxicity risk in sarcoma patients treated with anthracycline chemotherapy.The oncologist · 2025Article
- Anthracycline- and HER2-induced cardiotoxicity: mechanisms, current strategies, and the emerging role of dapagliflozin as a targeted cardioprotective agent.Cardio-oncology (London, England) · 2025Review
- Prognostic and therapeutic value of a 23-gene risk score tailored to the molecular characteristics of mucinous colorectal cancer.British journal of cancer · 2025Article
- Cardiac MRI for differentiating chemotherapy-induced cardiotoxicity in sarcoma and breast cancer.Radiology and oncology · 2025Article
- The interplay between doxorubicin chemotherapy, antioxidant system, and cardiotoxicity: Unrevealing of the protective potential of tannic acid.Biotechnology and applied biochemistry · 2025Article
- Effects of CAPE on biochemical, histopathological and cardiac parameters in doxorubicin induced cardiotoxicity.Northern clinics of Istanbul · 2025Article
- Diosmin and Coenzyme q10: Synergistic histopathological and functional protection against doxorubicin-induced hepatorenal injury in rats.Toxicology reports · 2024Article
- Cardiac Morbidity and Mortality in Patients with Sarcoma: A Population-Based Study.Clinical Medicine Insights. Oncology · 2024Article
- MMP-2 regulates Src activation via repression of the CHK/MATK tumor suppressor in osteosarcoma.Cancer reports (Hoboken, N.J.) · 2023Article
- Combination chemotherapy of doxorubicin and ifosfamide with proton beam therapy for myoepithelial carcinoma originating in the paraspinal region: A case report and literature review.Molecular and clinical oncology · 2022Article
- Alginate Microsphere Encapsulation of Drug-Loaded Nanoparticles: A Novel Strategy for Intraperitoneal Drug Delivery.Marine drugs · 2022Article
- Comparative effects of free doxorubicin, liposome encapsulated doxorubicin and liposome co-encapsulated alendronate and doxorubicin (PLAD) on the tumor immunologic milieu in a mouse fibrosarcoma model.Nanotheranostics · 2022Article
- Efficacy and safety of sintilimab plus doxorubicin in advanced soft tissue sarcoma: A single-arm, phase II trial.Frontiers in pharmacology · 2022Article
- Comparison between trabectedin and doxorubicin in soft-tissue sarcomas: a systematic review and meta-analysis.Annals of translational medicine · 2021Article
- Mechanism and prevention strategy of a bidirectional relationship between heart failure and cancer (Review).Experimental and therapeutic medicine · 2021Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe recommended cumulative doxorubicin dose in soft tissue sarcoma (STS) treatment was based on cardiotoxicity data from retrospective studies of breast cancer patients. However, the treatment and prognosis of STS and breast cancer are quite different, and reference to breast cancer data alone may not reflect the efficacy of doxorubicin treatment in STS. This study, thus, aimed to review and analyze clinical data of STS patients treated with a high cumulative doxorubicin dose, to provide a reference for treatment selection and clinical trial design.
methodsWe retrospectively collected and analyzed clinical data of patients with advanced STS who received doxorubicin-based chemotherapy from January 2016 to January 2020. The patients were divided into a standard-dose group (who received ≤6 cycles of doxorubicin after the initial diagnosis) and an over-dose group (who were re-administered doxorubicin [doxorubicin-rechallenge] after receiving 6 cycles of doxorubicin therapy discontinuously). Patient characteristics, cumulative doxorubicin dose, objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), cardiotoxicity incidence, and treatment effectiveness were evaluated in both groups.
resultsA total of 170 patients with advanced STS were recruited (146 in the standard-dose group and 24 in the over-dose group). The average cumulative doxorubicin dose was 364.04 ± 63.81 mg/m2 in the standard-dose group and 714.38 ± 210.09 mg/m2 in the over-dose group. The ORR, DCR, and median PFS were 15.07, 58.9%, and 6 (95% confidence interval [CI]: 5.8-6.5) months in the standard-dose group and 16.67, 66.67%, and 4 (95%CI: 2.0-5.8) months in the over-dose group, respectively. Symptomatic heart failure occurred in five patients (3.42%) of the standard-dose group and in one patient (4.17%) of the over-dose group. In these patients with cardiotoxicity, doxorubicin was discontinued, and all of them died of uncontrolled tumor growth. No drug-related deaths occurred.
conclusionsThe continuation of or rechallenge with doxorubicin beyond the recommended cumulative dose could be a promising therapeutic option in the treatment of chemotherapy-sensitive advanced sarcomas. Further evaluation is necessary in prospective trials.
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