Preoperative irradiation for soft tissue sarcomas of the trunk and extremities in adults.

Autor: Brant TA; University of Florida College of Medicine, Gainesville., Parsons JT, Marcus RB Jr, Spanier SS, Heare TC, van der Griend RA, Enneking WF, Million RR
Jazyk: angličtina
Zdroj: International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 1990 Oct; Vol. 19 (4), pp. 899-906.
DOI: 10.1016/0360-3016(90)90010-h
Abstrakt: Between May 1978 and January 1987, 58 adult patients with previously untreated sarcomas of the trunk and extremities were treated with preoperative irradiation and surgery at the University of Florida. All patients had a minimum of 2 years of follow-up; 24 had a minimum of 5 years of follow-up. The preoperative dose was usually 5040 cGy, with 120-125 cGy per fraction delivered twice daily. Operations were performed 2 to 6 weeks after radiation therapy. Eight patients received adjuvant chemotherapy. The tumors were high grade in 52 (90%), measured greater than 10 cm in 45 (78%), and were extracompartmental in 49 (84%). The surgical margins were wide in 17, marginal in 31, and intralesional in 10 patients. A functional extremity was preserved in 47 of 54 patients who would have required an amputation had they been treated by operation alone. Five of 58 patients (9%) developed local failure; in three, the failure occurred outside of the irradiated volume. Survival rates (product-limit method) at 5 years according to grade and size of lesion were as follows: low grade, 100%; high grade, 10 cm or less in largest diameter, 68%; high grade, 11-20 cm, 39%. Data are insufficient for a 5-year analysis of high-grade lesions greater than 20 cm; to date, there are no 5-year survivors in these patients. Moderate and severe wound complications occurred in 16%. There were four pathological fractures in 52 long bones at risk.
Databáze: MEDLINE