Intraoperative Radiotherapy of Soft Tissue Sarcoma of the Extremity
| Autor: | Annette Kretzler, Florian Würschmidt, Hans Ullrich Steinau, Reiner Gradinger, Peter Lukas, Michael Molls |
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| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Surgical margin Time Factors medicine.medical_treatment Brachytherapy Disease-Free Survival Humans Medicine Radiology Nuclear Medicine and imaging Aged Neoplasm Staging Retrospective Studies Aged 80 and over Univariate analysis Intraoperative Care business.industry Soft tissue sarcoma Soft tissue Sarcoma Middle Aged medicine.disease Combined Modality Therapy Survival Analysis Confidence interval Surgery Radiation therapy Treatment Outcome Oncology Female Radiology Neoplasm Recurrence Local Particle Accelerators business Intraoperative radiotherapy |
| Zdroj: | Strahlentherapie und Onkologie. 180:365-370 |
| ISSN: | 1439-099X 0179-7158 |
| DOI: | 10.1007/s00066-004-1191-8 |
| Popis: | PURPOSE: Evaluation of treatment outcome after intraoperative radiotherapy (IORT) +/- external-beam irradiation (EBRT) in patients with localized soft tissue sarcoma of the extremity at high risk for local recurrence after limb-sparing surgery. PATIENTS AND METHODS: 28 patients treated between 1989 and 1999 were evaluated retrospectively. Patients presented with locally recurrent (n = 17), T2 (n = 20), high-grade (n = 26), or incompletely resected tumors (n = 11). All patients underwent limbsparing surgery and IORT (median dose of 15 Gy) given either with high-dose-rate brachytherapy or a linear accelerator. 25 patients received additional EBRT with a mean of 50.6 Gy (range: 30.6-60 Gy). The mean follow-up time was 4.3 years (95% confidence interval [CI]: 3.0-5.6 years). RESULTS: The 5-year overall and distant disease-free survival rates were 66% and 54%, respectively. The overall actuarial recurrence rate after 5 years is 16% (95% CI: 1%, 31%). The crude rate after 8 years is 18%. Surgical margin status, primary versus recurrent tumor and tumor stage did not show any statistically significant influence (univariate analysis) on local recurrence rates. Patients with T1 tumors exhibited a borderline significant (p = 0.053) better distant disease-free survival (83%) compared to T2 tumors (43%). Five (24%) grade 3-4 late side effects were observed. CONCLUSION: In patients with high-risk soft tissue sarcomas, IORT +/- EBRT after limb-preserving surgery achieves high local control rates. The risk of normal tissue toxicities is comparable to conventional limb-sparing treatment. |
| Databáze: | OpenAIRE |
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