Adjuvant chemotherapy—Radiotherapy—Chemotherapy sandwich protocol in resectable soft tissue sarcoma: An updated single-center analysis of 104 cases

Adjuvant therapy of local soft tissue sarcomas (STS) after wide surgical excision still is a topic under controversial scientific debate. In this single center report we have offered an adjuvant “sandwich” therapy protocol consisting of 4 cycles of doxorubicin (75 mg/m2 i.v. over 1 h on day 1) followed by ifosfamide (5 g/m2 i.v. over 24 h starting on day 1) and local radiotherapy scheduled between chemotherapy cycles 2 and 3 to 104 consecutive patients after wide surgical excision (R0) of histologically proven high-grade STS. After a mean follow-up of 39 months (range 5–194 months) relapse free survival (RFS) at 2 and 5 years was 68.1% (95% CI, 58.5–77.7%) and 61.2% (95% CI, 50.4–71.6%). When analyzing the 82 STS cases of the extremities only 2- and 5-year RFS was 74.0% (95% CI, 64.0–84.0%) and 65.3% (95% CI, 53.7–76.9%). By intent-to-treat analysis, the overall survival (OS) at 2 years was 87.3% (95% CI, 80.5–94.1%) and 75.6% (95% CI, 65.2–86.0%) at 5 years, while OS for STS of the extremities only cohort was 90.5% (95% CI, 83.7–97.3%) and 79.0% (95% CI, 68.4–89.6%), respectively. Tolerability of the treatment was good. This analysis demonstrates the feasibility of adjuvant chemoradiotherapy and reflects the results of the long lasting intensive multidisciplinary team approach at our “high-volume” sarcoma center. The long-term survival in our patients is among the highest reported and the low local and distant recurrence rate in high-risk STS is at least comparable to the published data

Materialismo e primado do objeto em Adorno Materialism e priority of the object on Adorno

Este artigo investiga a "Tese" do primado do objeto na obra de Theodor W. Adorno, central ao seu materialismo não dogmático e relativamente pouco estudada. O primado do objeto será apresentado em seus elementos constitutivos, como crítica ao modo essencialmente idealista da dialética que perpassa o conjunto da obra de Adorno, em especial nos textos e discussões que precederam a publicação da Dialektik der Aufklãrung, para se explicitar no período de elaboração da Negative Dialektik. A "Tese" desenvolve momentos apresentados por Lukács, Benjamin e Horkheimer, particularmente quanto ao nexo entre razão e experiência e se fundamenta especialmente no trajeto Kant - Hegel, como crítica ao idealismo, incorporando de modo estruturante as perspectivas de Marx e de Nietzsche. Ao romper a pretensa "simetria" entre sujeito e objeto, a "Tese" do primado do objeto revela como é insustentável a alegação habermasiana do Discurso filosófico da modernidade segundo a qual Adorno e Horkheimer incidiriam num ceticismo total frente à razão e à sua totalização ideológica. Ao contrário: estes autores, ao articularem de um modo original substância material histórica e argumentação teórica, contribuíram de modo fundamental para examinar o problema da reificação mediante sua relação à objetividade - como o não-idêntico - no âmbito da razão.<br>The thesis of the priority of the object, essential to Adorno's non dogmatic materialism, is analyzed in its constitutive elements, as a criticism of idealism which is present mainly at the works Dialectic of enlightenment and Negative dialectic. As a criticism of idealism, particularly on the relationships between reason and experience as first developed from Kant to Hegel, the thesis is based on Lukács, Benjamin, and Horkheimer contributions and is embedded on the perspectives of Marx and Nietzsche. With its disruption of symmetry between subject and object, the thesis of the priority of the object reveals the frailty of Habermas assertion, in his Philosophical discourse of modernity, of Adorno's and Horkheimer's skepticism towards reason. The present author argues that, in opposition to this claim, Adorno and Horkheimer contributed, with their new way of relating historical material and theoretical approach, to the analysis of the problem of reification in its relations to objectivity - as the non-identical - within the realm of reason, and not outside of it