A prospective randomized trial of adjuvant brachytherapy in the management of low-grade soft tissue sarcomas of the extremity and superficial trunk Journal Article


Authors: Pisters, P. W. T.; Harrison, L. B.; Woodruff, J. M.; Gaynor, J. J.; Brennan, M. F.
Article Title: A prospective randomized trial of adjuvant brachytherapy in the management of low-grade soft tissue sarcomas of the extremity and superficial trunk
Abstract: Purpose: This study was designed to evaluate the impact of adjuvant brachytherapy (BRT) on local and systemic recurrence rates in patients with low-grade sarcoma. Patients and Methods: Forty-five patients with histologic low-grade, completely resected soft tissue sarcomas of the extremity or superficial trunk were entered onto this trial. Following resection of all gross disease, patients were randomized to the BRT arm (n = 22) or to the no- BRT arm (n = 23). On the fifth or sixth postoperative day, catheters were loaded with iridium 192 to deliver a dose of 45 Gy to the tumor bed over 4 to 6 days. Results: The two groups were evenly distributed with respect to the distribution of presentation status (primary v recurrent), tumor site (trunk v extremity, proximal v distal extremity), tumor size (< 5 cm v ≥ 5 cm), tumor depth (superficial v deep), and microscopic tumor margins (positive v negative). The predominant histopathologic diagnosis in each group was liposarcoma (BRT, 13 of 22 [59%]; no BRT, 14 of 23 [61%]) with other histopathologic subtypes evenly distributed between the two groups. The median follow-up duration among the ongoing survivors is 67 months. One patient in the BRT group developed systemic disease and died of progressive disease. Local recurrence occurred in five of 23 patients (22%) in the no- BRT group and six of 22 patients (27%) in the BRT group (P = .60). Conclusion: Adjuvant radiation in the form of BRT does not appear to decrease local recurrence rates following complete resection of low-grade extremity and superficial trunk soft tissue sarcomas. Other adjuvant approaches, such as external-beam radiotherapy, are required to have a significant impact on local recurrence rates in this group of patients.
Keywords: adult; cancer survival; clinical article; controlled study; clinical trial; cancer localization; cancer recurrence; controlled clinical trial; tumor volume; soft tissue sarcoma; brachytherapy; iridium 192; beam therapy; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 12
Issue: 6
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1994-06-01
Start Page: 1150
End Page: 1155
Language: English
DOI: 10.1200/jco.1994.12.6.1150
PROVIDER: scopus
PUBMED: 8201376
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Murray F Brennan
    1059 Brennan
  2. James M Woodruff
    162 Woodruff
  3. Louis B Harrison
    123 Harrison
  4. Peter W. T. Pisters
    21 Pisters
  5. Jeffrey J. Gaynor
    36 Gaynor