Intensity modulated radiation therapy for primary soft tissue sarcoma of the extremity: Preliminary results Journal Article


Authors: Alektiar, K. M.; Hong, L.; Brennan, M. F.; Della-Biancia, C.; Singer, S.
Article Title: Intensity modulated radiation therapy for primary soft tissue sarcoma of the extremity: Preliminary results
Abstract: Purpose: To report preliminary results on using intensity modulated radiation therapy (IMRT) as an adjuvant treatment in primary soft tissue sarcoma (STS) of the extremity. Methods and Materials: Between February 2002 and March 2005, 31 adult patients with primary STS of the extremity were treated with surgery and adjuvant IMRT. Tumor size was >10 cm in 74% of patients and grade was high in 77%. Preoperative IMRT was given to 7 patients (50 Gy) and postoperative IMRT (median dose, 63 Gy) was given to 24 patients. Complete gross resection including periosteal stripping or bone resection was required in 10, and neurolysis or nerve resection in 20. The margins were positive or within 1 mm in 17. Complications from surgery and radiation therapy (RT) were assessed using the Common Terminology Criteria for Adverse Events grading system. Results: Median follow-up time was 23 months. Grade 1 RT dermatitis developed in 71% of patients, Grade 2 in 16%, and Grade 3 in 10%. Infectious wound complications developed in 13% and noninfectious complications in 10%. Two patients (6.4%) developed fractures. Grade 1 neuropathy developed in 28% of patients and Grade 2 in 5%. The rates of Grade 1 and 2 joint stiffness were each 19%. Grade 1 edema was observed in 19% of patients and Grade 2 in 13%. The 2-year local control, distant control, and overall survival were 95%, 65%, and 81%, respectively. Conclusion: Intensity modulated RT appears to provide excellent local control in a difficult group of high-risk patients. The morbidity profile is also favorable, but longer follow-up is needed to confirm the results from this study. © 2007 Elsevier Inc. All rights reserved.
Keywords: adult; cancer survival; clinical article; controlled study; aged; aged, 80 and over; middle aged; cancer surgery; fracture; intensity modulated radiation therapy; cancer radiotherapy; postoperative care; radiotherapy, adjuvant; follow up; preoperative evaluation; edema; tumor volume; neuropathy; radiotherapy dosage; radiotherapy; oncology; risk assessment; sarcoma; postoperative complications; disease severity; patients; imrt; tumors; radiotherapy, intensity-modulated; limb tumor; soft tissue sarcoma; extremities; surgery; dermatitis; wound infection; neurology; neurolysis; joint stiffness; primary; extremity; radiodermatitis; bone resection; noninfectious complications; soft tissue sarcoma (sts); nerve surgery; patella; tibial fractures
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 68
Issue: 2
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2007-01-01
Start Page: 458
End Page: 464
Language: English
DOI: 10.1016/j.ijrobp.2006.12.054
PUBMED: 17363186
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 20" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus"
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MSK Authors
  1. Murray F Brennan
    782 Brennan
  2. Kaled M Alektiar
    253 Alektiar
  3. Linda Xueqi Hong
    47 Hong
  4. Samuel Singer
    233 Singer