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Purpose Multimodality treatment of soft tissue sarcoma(STS) by expert teams reportedly affords a tremendous improvement in outcome of patients. Despite advances, treatment of local unresectable recurrence remains difficult and is not standardized. We performed this retrospective study in order to assess the efficacy and safety of high-intensity focused ultrasound (HIFU) ablation in treating STS patients with local unresectable recurrence. Methods Thirty-six STS patients with local unresectable recurrence from January 2015 to December 2016 were recruited according to the inclusion criteria. Pain rating, response rate, disease control rate, local disease progression-free survival(LPFS), progression-free survival (PFS) and overall survival(OS) were used to evaluate efficacy of HIFU treatment. Results HIFU resulted in a significant relief in pain rating, without severe side effects. According to magnetic resonance imaging(MRI), three months after HIFU treatment, response rate was 47.3% and the local disease control rate was 80.6%. Twelve months post HIFU treatment, response rate was 38.9% and the local disease control rate was 55.6%. The median LPFS, PFS and OS time for 36 patients was 13 months, 10 months and 20 months respectively. Conclusion HIFU is a tolerated treatment modality with promising activity and safety in STS patients with local unresectable recurrence.

Objective Local unresectable recurrence of osteosarcoma is one of the most challenging tumors to treat. High-intensity focused ultrasound (HIFU) is a new, noninvasive technique with potential to ablate and inactivate tumors. Treatment of solid tumors with HIFU has been reported. In this study, we assessed safety and efficacy of HIFU in treating local unresectable recurrence of osteosarcoma. Methods We performed a retrospective analysis of 27 patients who had local unresectable recurrence of osteosarcoma from 2006 to 2010. Changes of biochemical markers and pain rating, response rate, disease control rate, local disease progression-free survival, progression-free survival (PFS) and overall survival (OS) were used to evaluate efficacy of HIFU treatment. Results HIFU resulted in a significant change in alkaline phosphatase and lactic acid dehydrogenase and a remarkably relief in pain rating, without severe side effects. According to MRI examination 4–6 weeks after HIFU treatment, 2 (7.4%) patients had complete response (CR), 12 (44.4%) had partial response (PR), 9 (33.3%) had stable disease (SD) and 4 (14.8%) had progression disease (PD). The response rate was 51.8% and the local disease control rate was 85.2%. The 1-, 2-, and 3-year local disease control rates were 59.2%, 40.7% and 33.1%, respectively. The median local disease progression-free time was 14 months, the median progression-free time was 13 months and the median over-all survival time was 21 months. Patients without pulmonary metastasis had a better local disease control rate at 1-,2-,3-year and a longer local disease progression-free time, progression-free time, over-all survival time than patients with pulmonary metastasis. Conclusion HIFU is a safe and noninvasive treatment for local unresectable recurrence of osteosarcoma, with good local control and without severe complications.