Five-year Results From A Scandinavian Sarcoma Group Study (SSG XIII) Of Adjuvant Chemotherapy Combined With Accelerated Radiotherapy In High-Risk Soft Tissue Sarcoma Of Extremities And Trunk Wall

Summary, in English

Purpose: To evaluate adjuvant chemotherapy and interpolated accelerated radiotherapy (RT) for adult patients with high-risk soft tissue sarcoma in the extremities or trunk wall. Methods and Materials: High-risk soft tissue sarcoma was defined as high-grade malignancy and at least two of the following criteria: size >= 8 cm, vascular invasion, or necrosis. Six cycles of doxorubicin and ifosfamide were prescribed for all patients. RT to a total dose of 36 Gy (1.8 Gy twice daily) was inserted between two chemotherapy cycles after marginal margin resection regardless of tumor depth or after wide-margin resection for deep-seated tumors. RT was boosted to 45 Gy in a split-course design in the case of intralesional margin resection. Results: A total of 119 patients were eligible, with a median follow-up of 5 years. The 5-year estimate of the local recurrence, metastasis-free survival, and overall survival rate was 12%, 59%, and 68%, respectively. The group receiving RT to 36 Gy had a local recurrence rate of 10%. In contrast, the local recurrence rate was 29% in the group treated with RT to 45 Gy. The presence of vascular invasion and low chemotherapy dose intensity had a negative effect on metastasis-free and overall survival. Toxicity was moderate after both the chemotherapy and the RT. Conclusions: Accelerated RT interposed between chemotherapy cycles in a selected population of patients with high-risk soft tissue sarcoma resulted in good local and distant disease control, with acceptable treatment-related morbidity. The greater radiation dose administered after intralesional surgery was not sufficient to compensate for the poorer surgical margin. Vascular invasion was the most important prognostic factor for metastasis-free and overall survival. (C) 2011 Elsevier Inc.

• Författare: Nina L. Jebsen; Oyvind S. Bruland; Mikael Eriksson; Jacob Engellau; Ingela Turesson; Annika Folin; Clement S. Trovik; Kirsten Sundby Hall
• Avdelning/ar: Bröstcancer-genetik
• Publiceringsår: 2011
• Språk: Engelska
• Sidor: 1359-1366
• Publikation/Tidskrift/Serie: International Journal of Radiation Oncology, Biology, Physics
• Volym: 81
• Issue: 5
• Länkar: http://dx.doi.org/10.1016/j.ijrobp.2010.07.037
• Dokumenttyp: Artikel i tidskrift
• Förlag: Elsevier
• Ämne: Radiology, Nuclear Medicine and Medical Imaging
• Nyckelord: Soft tissue sarcoma; Adjuvant treatment; Accelerated radiotherapy; Chemotherapy; Prognostic factors
• Aktiv: Published
• ISBN/ISSN/Övrigt: ISSN: 0360-3016