Preoperative Thalidomide With Radiation Therapy For Patients With Low-Grade Primary Soft Tissue Sarcoma or Thalidomide With Radiation Therapy and Chemotherapy For Patients With High-Grade or Intermediate-Grade Primary Soft Tissue Sarcoma of the Arm, Leg, or Body Wall

Inclusion Criteria

• •Diagnosis of primary soft tissue sarcoma
• •* T2a or T2b disease
• •* Superficial or deep tumor
• •* Grade 1, 2, 3, or 4
• •* Tumor located on the upper extremity (including shoulder), lower extremity (including hip), or trunk
• •Meets 1 of the following criteria:
• •* Tumor ? 8 cm in maximal diameter and grade 3 or 4 (intermediate or high grade) (cohort A)
• •* Tumor \> 5 cm in maximal diameter and grade 1 or 2 (low grade) (cohort B)
• •Locally recurrent disease allowed provided there has been no prior radiotherapy to the primary tumor
• •No histologically confirmed rhabdomyosarcoma, extraosseous Ewing's primitive neuroectodermal tumors, osteosarcoma or chondrosarcoma, Kaposi's sarcoma, angiosarcoma, desmoid tumors, or dermatofibrosarcoma protuberans
• •No overt evidence of lung metastases (CT scan evidence of small incidental lesions without histologic diagnosis allowed)
• •No evidence of other metastases
• •No sarcoma of the head, neck, intra-abdominal, or retroperitoneal region
• •Performance status - Zubrod 0-1
• •At least 2 years
• •Absolute neutrophil count ? 1,500/mm\^3
• •Platelet count ? 120,000/mm\^3
• •Hemoglobin ? 8.0 g/dL (cohort A)
• •No known hypercoagulable disorders, such as the following:
• •* APC resistance (factor V Leiden)
• •* Protein S deficiency
• •* Protein C deficiency
• •* Antithrombin III deficiency
• •* Hyperhomocystinemia
• •* Dysplasminogenemia
• •* High plasminogen activator inhibitor
• •* Dysfibrinogenemia
• •* Antiphospholipid syndrome
• •* Thrombocythemia
• •* Dysproteinemia
• •Fibrin split products \< 2 times upper limit of normal (ULN)
• •Fibrinogen \> 200 mg/dL
• •Bilirubin ? 1.5 mg/dL (1.0 mg/dL for patients with Gilbert's syndrome)
• •AST and ALT ? 2.0 times ULN
• •PT and PTT \< 1.25 times ULN (except in patients treated with anticoagulants for unrelated medical conditions \[e.g., atrial fibrillation\])
• •No history of hepatic cirrhosis
• •Creatinine ? 1.5 mg/dL
• •Creatinine clearance \> 60 mL/min
• •No atherosclerotic coronary artery disease that required bypass surgery within the past year
• •No uncompensated coronary artery disease by ECG or physical examination
• •No myocardial infarction within the past 6 months
• •No severe or unstable angina within the past 6 months
• •No uncompensated congestive heart failure
• •No New York Heart Association class II-IV heart disease
• •No symptomatic peripheral vascular disease
• •No history of deep vein thrombosis
• •Cohort A only:
• •* EF ? 50% within the past 6 months
• •* LVEF \> 50%
• •No pulmonary embolus except if caused directly by foreign body implants (e.g., central venous catheters or portacaths)
• •No global neurocognitive symptomatology
• •No fatigue ? grade 2
• •No history of uncontrolled seizures or uncontrolled seizure disorder
• •No sensory neuropathy ? grade 2 except for localized neuropathy due to mechanical cause or trauma
• •No other malignancies within the past 3 years except non-invasive malignancies (e.g., carcinoma in situ of the cervix, breast, or oral cavity) or squamous or basal cell skin cancer
• •No history of uncontrolled myxedema
• •No hypothyroidism ? grade 3
• •No active uncontrolled bacterial, viral, or fungal infection
• •No other significant illness that would preclude surgery
• •No other major illness or psychiatric impairment that would preclude study therapy
• •No known AIDS
• •Not pregnant or nursing
• •Negative pregnancy test
• •Fertile patients must use 2 effective barrier methods of contraception for 4 weeks before, during, and for at least 4 weeks after study treatment
• •No prior thalidomide
• •No prior biologic therapy for this tumor
• •No prior chemotherapy for this tumor
• •See Disease Characteristics
• •No prior radiotherapy for this tumor
• •See Cardiovascular
• •No other concurrent investigational drugs
• •No concurrent sedating drugs
• •No concurrent illegal sedating "recreational" drugs
• •No concurrent alcohol intake of more than 1 drink per day