Intraoperative electron boost radiation followed by moderate doses of external beam radiotherapy in limb-sparing treatment of patients with extremity soft-tissue sarcoma

To analyze long-term prognosis and morbidity after limb-sparing treatment of patients with extremity soft-tissue sarcoma, with intraoperative electron boost radiotherapy (IOERT) followed by a moderate dose of external beam radiotherapy (EBRT). A total of 153 patients who were treated in a single cen...

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Bibliographic Details
Published in:	International journal of radiation oncology, biology, physics Vol. 64; no. 5; p. 1416
Main Authors:	Oertel, Susanne, Treiber, Martina, Zahlten-Hinguranage, Angelika, Eichin, Steffen, Roeder, Falk, Funk, Angela, Hensley, Frank W, Timke, Carmen, Niethammer, Andreas G, Huber, Peter E, Weitz, Juergen, Eble, Micheal J, Buchler, Markus W, Bernd, Ludger, Debus, Jürgen, Krempien, Robert C
Format:	Journal Article
Language:	English
Published:	United States 01-04-2006
Subjects:	Adolescent Adult Aged Aged, 80 and over Electrons - therapeutic use Extremities Female Humans Limb Salvage - methods Male Middle Aged Neoplasm Recurrence, Local - surgery Radiotherapy - methods Sarcoma - mortality Sarcoma - radiotherapy Sarcoma - surgery Survival Rate
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Summary:	To analyze long-term prognosis and morbidity after limb-sparing treatment of patients with extremity soft-tissue sarcoma, with intraoperative electron boost radiotherapy (IOERT) followed by a moderate dose of external beam radiotherapy (EBRT). A total of 153 patients who were treated in a single center from 1991 to 2004 were evaluated. Median IOERT dose was 15 Gy, mean EBRT dose 43 Gy (range, 40-50.4 Gy) in conventional fractionation (1.8-2 Gy). Median duration of follow-up was 33 months. Acute toxicity was assessed with Common Toxicity Criteria; late toxic effects were scored according to European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. Five-year overall survival and 5-year local control rates were 77% and 78%, respectively. Whereas tumor size, patient age, and EBRT dose did not significantly affect outcome, resection status and grading were significant for survival; resection status and IOERT dose were significant for local control. Extremity salvage until death or time of follow-up was achieved in 90% of our patients, 86% of whom showed excellent limb function without impairment in activities of daily life. Acute toxicity Grade 2-4 was observed in 23% and late toxicity Grade 2-4 in 17% of patients. Treatment with IOERT combined with moderate doses of external beam irradiation yields high local control and extremity preservation rates in resected extremity soft-tissue sarcoma.
ISSN:	0360-3016
DOI:	10.1016/j.ijrobp.2005.10.009