Complications of radiation therapy to the hand after soft tissue sarcoma surgery Journal Article

Authors: Rohde, R. S.; Puhaindran, M. E.; Morris, C. D.; Alektiar, K. M.; Schupak, K. D.; Healey, J. H.; Athanasian, E. A.
Article Title: Complications of radiation therapy to the hand after soft tissue sarcoma surgery
Abstract: Purpose Radiation has been shown to improve local control after resection of soft tissue sarcomas. However, it may also result in major complications in the hand, given the compact nature of functional tissues and limited tissue volumes in the hand. The purpose of this investigation was to describe the hand-specific complications of radiation therapy for patients with soft tissue sarcoma of the hand (STSH). Methods We performed a retrospective chart review of 55 consecutive patients with STSH treated by a single surgeon between 1993 and 2006. We identified 26 patients who were treated with external beam radiation, brachytherapy, or both, either preoperatively or postoperatively, and reviewed their clinical course. Results After a median follow-up of 7 years, 29 treatment-related complications occurred in 19 patients who had received radiation, whereas 3 of the 29 patients treated with surgery alone developed complications. All patients who received brachytherapy and 14 of the 21 treated with external beam radiation alone developed complications. There were 5 early minor, 2 early major, 3 late minor, and 19 late major complications. Conclusions Patients with STSH who underwent radiation therapy had a high rate of complications. The complication rate in our series was higher in patients who had brachytherapy catheters placed adjacent to finger joints. A better understanding of predictors of complications will help to determine the optimal timing and type of radiation therapy to treat patients with STSH. Type of study/level of evidence Therapeutic IV. © 2010 American Society for Surgery of the Hand All rights reserved.
Keywords: adolescent; adult; child; clinical article; treatment outcome; aged; aged, 80 and over; middle aged; cancer surgery; retrospective studies; young adult; postoperative care; preoperative care; radiotherapy, adjuvant; follow-up studies; magnetic resonance imaging; neoplasm staging; cohort studies; radiation; incidence; tomography, x-ray computed; radiation injury; time factors; risk assessment; dose-response relationship, radiation; sarcoma; soft tissue sarcoma; brachytherapy; complications; external beam radiotherapy; osteoradionecrosis; orthopedic procedures; hand; hand tumor; fractures, spontaneous
Journal Title: Journal of Hand Surgery
Volume: 35
Issue: 11
ISSN: 0363-5023
Publisher: Elsevier Inc.  
Date Published: 2010-11-01
Start Page: 1858
End Page: 1863
Language: English
DOI: 10.1016/j.jhsa.2010.08.030
PUBMED: 20961705
PROVIDER: scopus
Notes: --- - "Export Date: 20 April 2011" - "CODEN: JHSUD" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Kaled M Alektiar
    260 Alektiar
  2. Carol Morris
    54 Morris
  3. Karen D Schupak
    70 Schupak
  4. John H Healey
    406 Healey