Adjuvant radiation for stage II-B soft tissue sarcoma of the extremity Journal Article
| Authors: | Alektiar, K. M.; Leung, D.; Zelefsky, M. J.; Brennan, M. F. |
| Article Title: | Adjuvant radiation for stage II-B soft tissue sarcoma of the extremity |
| Abstract: | Purpose: Adjuvant radiation therapy (RT) has been shown to improve local control in patients with highgrade soft tissue sarcoma (STS) of the extremity. This study sought to define the optimal management in patients with stage II-B (high-grade, size ≤5 cm) tumors. Patients and Methods: Between July 1982 and December 1998, 204 adult patients with primary stage II-B STS underwent limb-sparing surgery with negative microscopic margins. Eighty-eight patients (43%) received RT; 116 (57%) did not. The RT and no-RT groups were balanced with regard to age, site (upper v lower extremity), whether patients had prior unplanned excision, and location (central, ie, shoulder/groin v non-central). The RT group had more deep tumors (P = .03). Adjuvant RT was delivered with brachytherapy in 60% and external-beam radiation in 40% of patients. Results: With a median follow-up of 67 months, the 5-year local control, distant relapse-free survival, and disease-specific survival rates were 82%, 80%, and 88%, respectively. There was no significant difference in local control between the RT and no-RT groups (84% v 80%, respectively, P = .3). Tumor depth, site, and prior unplanned excision did not correlate with local control. The only independent predictors of poor local control were central tumor location (relative risk [RR] = 3; 95% confidence interval [CI], 2 to 7; P = .005) and age more than 50 years (RR = 6; 95% CI, 2 to 13; P = .001). Conclusion: In this retrospective study, adjuvant RT did not significantly improve local control in patients with stage II-B STS of the extremity. The outcome of patients with central tumor location was poor, and efforts to identify the optimal local treatment approach far such patients are warranted. © 2002 by American Society of Clinical Oncology. |
| Keywords: | adolescent; adult; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; major clinical study; cancer localization; cancer adjuvant therapy; cancer radiotherapy; radiotherapy, adjuvant; cancer staging; proportional hazards models; radiotherapy dosage; relapse; retrospective study; sarcoma; correlation analysis; cancer size; limb tumor; soft tissue sarcoma; extremities; brachytherapy; outcomes research; chi-square distribution; soft tissue neoplasms; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 20 |
| Issue: | 6 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2002-03-15 |
| Start Page: | 1643 |
| End Page: | 1650 |
| Language: | English |
| DOI: | 10.1200/jco.20.6.1643 |
| PUBMED: | 11896115 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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