Prognostic variables in patients with primary soft tissue sarcoma of the extremity and trunk treated with neoadjuvant radiotherapy or neoadjuvant sequential chemoradiotherapy. Radiat Oncol 2013 Mar 14;8:60
Date
03/19/2013Pubmed ID
23497372Pubmed Central ID
PMC3621722DOI
10.1186/1748-717X-8-60Scopus ID
2-s2.0-84874932091 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
BACKGROUND: Neoadjuvant radiotherapy (NRT) is an effective strategy to treat soft tissue sarcomas (STS). However, the role of neoadjuvant chemoradiotherapy (NCRT) remains to be determined.
METHODS: From May 1999 to July 2010, 112 patients with localized STS of the extremity and trunk who were treated with NRT or NCRT followed by surgery were retrospectively reviewed. Clinical outcomes including overall survival (OS), disease-free survival (DFS), and distant metastasis free survival (DMFS) were calculated using Kaplan-Meier survival analyses. Prognostic variables were determined by univariate (UVA) and multivariate analyses (MVA).
RESULTS: Median follow-up was 37 months. Median RT dose was 50 Gy. Forty-nine patients received NCRT. Overall limb-preservation rate was 99% and local control was 97%. The estimated 3-year OS, DFS, and DMFS were 86%, 68%, and 72%, respectively. Age was the only variable to predict for OS, DFS and DMFS on UVA. Age ≥ 70 predicted for poor OS, stage III disease predicted for poor DFS and DMFS, and the addition of chemotherapy predicted for improved DMFS on MVA.
CONCLUSIONS: Excellent rates of local control and limb-preservation were observed in patients with primary STS treated with neoadjuvant therapy followed by surgery. Neoadjuvant sequential chemotherapy followed by radiotherapy may be considered for young patients with stage III STS.
Author List
Bedi M, King DM, Shivakoti M, Wang T, Zambrano EV, Charlson J, Hackbarth D, Neilson J, Whitfield R, Wang DAuthors
Manpreet Bedi MD, MS Professor in the Radiation Oncology department at Medical College of WisconsinJohn A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
John C. Neilson MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
Tao Wang PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Chemoradiotherapy
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoadjuvant Therapy
Prognosis
Radiotherapy, Adjuvant
Retrospective Studies
Sarcoma
Young Adult
