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Reirradiation in Conservative Salvage of Recurrent Soft-tissue Sarcoma: An Analysis of Treatment Efficacy and Toxicities.
- Source :
-
American journal of clinical oncology [Am J Clin Oncol] 2021 Dec 01; Vol. 44 (12), pp. 624-628. - Publication Year :
- 2021
-
Abstract
- Objective: Compared with radical resection alone, perioperative radiation therapy (RT) combined with neurovascular preserving surgery is the standard for the management of virgin soft-tissue sarcomas. Yet, the optimal management of a local recurrence remains unclear. We report outcomes of patients with locally recurrent soft-tissue sarcoma treated with resection and reirradiation at the University of Florida.<br />Materials and Methods: We reviewed the records of patients treated with primary conservative surgery and radiation for soft-tissue sarcoma followed by salvage resection and reirradiation for a local recurrence at our institution.<br />Results: We analyzed 23 patients treated between 1976 and 2014 (median follow-up, 46 mo). Tumor sites included: proximal extremity, 11 patients; trunk, 6; distal extremity, 5; and head and neck, 1. All patients had conservative gross total resection of their recurrent tumor, without amputation. For reirradiation, 16 patients received external-beam RT alone, 6 received external-beam RT and brachytherapy, and 1 received brachytherapy alone. Two patients received chemotherapy. After retreatment, the 5-year overall survival, cause-specific survival, local control, and distant control rates were 39%, 42%, 46%, and 60%, respectively. Ten patients experienced local recurrences, 1 experienced regional recurrence, and 9 developed distant metastases. Retreatment-related complications ranged from delayed wound healing to limb amputation; 8 patients required amputation. Only 3 patients remained disease-free at last follow-up. No statistically significant associations were found between treatment factors (eg, RT dose) and local control.<br />Conclusions: Achieving local control of recurrent soft-tissue sarcoma is challenging. Treatment with reoperation and reirradiation can lead to debilitating complications affecting function and quality of life.<br />Competing Interests: The authors declare no conflicts of interest.<br /> (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Brachytherapy adverse effects
Child
Female
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
Salvage Therapy
Sarcoma mortality
Sarcoma pathology
Sarcoma surgery
Soft Tissue Neoplasms mortality
Soft Tissue Neoplasms pathology
Soft Tissue Neoplasms surgery
Treatment Outcome
Young Adult
Re-Irradiation adverse effects
Sarcoma radiotherapy
Soft Tissue Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 1537-453X
- Volume :
- 44
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- American journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 34753882
- Full Text :
- https://doi.org/10.1097/COC.0000000000000874