Radiation therapy and conservativ surgery for soft tissue sarcomas of the extremities, torso and head and neck

A. De Paoli, G. Bertola, G. Boz, F. Gherlinzoni, S. Frustaci, G. Fumo, R. Innocente, M. G. Trovo, C. Rossi, A. Carbone, S. Morassut

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Between May 1985 and July 1990, 45 patients (pts.) with primary (39) or recurrent (6) soft tissue sarcomas of the extremities (82%), torso (11%) and head and neck (7%) were treated with radiation therapy and conservative surgery. Seven pts. not amenable to conservative surgery underwent preoperative radiation therapy whereas 38 pts. underwent local excision and post-operative radiation therapy. Out of the 38 pts. managed by postoperative radiation, 24 (63%) showed negative surgical margins and 14 (37%) positive margins, their tumor being adjacent to vital structures. Preoperative radiation allowed conservative surgery in all 7 pts. withinitially inoperable tumor; surgical margins were negative in 5 and positive in 2 pts. Twenty-six pts. (58%) had tumor ≥5 cm (5-24) and 19 (42%)<5 cm (2.5-4.5) in diameter. High grade tumors (G2-G3) were reported in 41 pts. (90%). In pts. treated postoperatively the radiation dose was 64-66 Gy/32-33 fractions and the pts. treated preoperatively received a dose of 50 Gy/25 fractions. Median follow-up was 33 months and all pts. had a minimum follow-up of 12 months (12-72). Three pts. (6.5%) had local failure and 9 (20%) developed distant metastases with local tumor control. All distant metastases occurred in AJC stage IIIB, 9/18 (50%), with an increased frequency by tumor size. Overall local control and disease free survival rates at 5 years (product-limit method) were 93% and 73%, respectively. An evident decrease in disease-free survival rate (33%) was noted for stage IIIB pts. Treatment complications occurred in 11% of pts. and consisted mainly in prolonged wound healing for pts. treated with preoperative radiation therapy. Our experience confirms the high local control rate reported from several Centers with radiation therapy and conservative surgery for soft tissue sarcomas. The incidence of distant metastases for large, high grade lesions is the major problem in these patients.

Original languageEnglish
Pages (from-to)97-101
Number of pages5
JournalAnnals of Oncology
Issue numberSUPPL. 2
Publication statusPublished - 1992

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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