Long-term clinical outcome of patients with soft tissue sarcomas treated with limb-sparing surgery and postoperative radiotherapy

• Published in: Acta oncologica 2013-05, Vol.52 (4), p.745-752
• Main Authors: Felderhof, Joeke M., Creutzberg, Carien L., Putter, Hein, Nout, Remi A., Bovée, Judith V. M. G., Dijkstra, P. D. Sander, Hartgrink, Henk H., Marijnen, Corrie A. M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Combined Modality Therapy; Extremities - surgery; Female; Follow-Up Studies; Humans; Male; Middle Aged; Organ Sparing Treatments - methods; Postoperative Period; Radiation Injuries - epidemiology; Radiation Injuries - etiology; Radiotherapy Dosage; Radiotherapy, Adjuvant; Sarcoma - mortality; Sarcoma - radiotherapy; Sarcoma - surgery; Severity of Illness Index; Survival Analysis; Survivors - statistics & numerical data; Treatment Outcome
• ISSN: 0284-186X; 1651-226X
• DOI: 10.3109/0284186X.2012.709947

Abstract Background. To evaluate long-term local control, survival, radiation side effects and functional outcome after limb-sparing surgery followed by postoperative radiotherapy (RT) for soft tissue sarcoma (STS). Material and methods. Between 1995 and 2010, 118 patients with STS of an extremity were treated with limb-sparing surgery and postoperative RT. Follow-up was complete for all patients. Acute and late radiation related toxicities were scored using CTCAE v4.0. Results. Median follow-up was 93 months. RT dose was 60 Gy in 92.4% of the patients; 5.1% received 66 Gy; 2.5% 50-56 Gy. Actuarial local recurrence rates at five and 10 years were 9% and 12%. Five- and 10-year overall survival rates were 69% and 51%. Acute radiation toxicities occurred in 91% of the patients; 19% were grade 3, 2% grade 4. Late radiation toxicities were reported in 71% of the patients: 50% grade 1, 18% grade 2, and 3% grade 3. Limb and joint function after treatment were good, 19% having mild limitation of motion, 1.5% moderate, and 2.5% severe limitations. Conclusion. Limb-sparing surgery with 60 Gy postoperative radiotherapy for patients with STS provides excellent local control and high survival rates with acceptable toxicity and functional outcomes.