Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma
Identifieur interne : 003D81 ( Main/Exploration ); précédent : 003D80; suivant : 003D82Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma
Auteurs : Jieun Lee [Corée du Sud] ; Young Je Park [Corée du Sud] ; Dae Sik Yang [Corée du Sud] ; Won Sup Yoon [Corée du Sud] ; Jung Ae Lee [Corée du Sud] ; Chai Hong Rim [Corée du Sud] ; Chul Yong Kim [Corée du Sud]Source :
- Radiation Oncology Journal [ 2234-1900 ] ; 2012.
Abstract
To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS).
Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy.
The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%).
Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.
Url:
DOI: 10.3857/roj.2012.30.2.62
PubMed: 22984684
PubMed Central: 3429890
Affiliations:
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Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Yang, Dae Sik" sort="Yang, Dae Sik" uniqKey="Yang D" first="Dae Sik" last="Yang">Dae Sik Yang</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Yoon, Won Sup" sort="Yoon, Won Sup" uniqKey="Yoon W" first="Won Sup" last="Yoon">Won Sup Yoon</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Lee, Jung Ae" sort="Lee, Jung Ae" uniqKey="Lee J" first="Jung Ae" last="Lee">Jung Ae Lee</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région 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Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Park, Young Je" sort="Park, Young Je" uniqKey="Park Y" first="Young Je" last="Park">Young Je Park</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Yang, Dae Sik" sort="Yang, Dae Sik" uniqKey="Yang D" first="Dae Sik" last="Yang">Dae Sik Yang</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Yoon, Won Sup" sort="Yoon, Won Sup" uniqKey="Yoon W" first="Won Sup" last="Yoon">Won Sup Yoon</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Lee, Jung Ae" sort="Lee, Jung Ae" uniqKey="Lee J" first="Jung Ae" last="Lee">Jung Ae Lee</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Rim, Chai Hong" sort="Rim, Chai Hong" uniqKey="Rim C" first="Chai Hong" last="Rim">Chai Hong Rim</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Kim, Chul Yong" sort="Kim, Chul Yong" uniqKey="Kim C" first="Chul Yong" last="Kim">Chul Yong Kim</name><affiliation wicri:level="3"><nlm:aff id="A1">Department of Radiation Oncology, Korea University Medical Center, Seoul, Korea.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Corée du Sud</country><wicri:regionArea>Department of Radiation Oncology, Korea University Medical Center, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></analytic><series><title level="j">Radiation Oncology Journal</title><idno type="ISSN">2234-1900</idno><idno type="eISSN">2234-3164</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS).</p></sec><sec><title>Materials and Methods</title><p>Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy.</p></sec><sec><title>Results</title><p>The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%).</p></sec><sec><title>Conclusion</title><p>Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Korah, Mp" uniqKey="Korah M">MP Korah</name></author><author><name sortKey="Deyrup, At" uniqKey="Deyrup A">AT Deyrup</name></author><author><name sortKey="Monson, Dk" uniqKey="Monson D">DK Monson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosenberg, Sa" uniqKey="Rosenberg S">SA Rosenberg</name></author><author><name sortKey="Tepper, J" uniqKey="Tepper J">J Tepper</name></author><author><name sortKey="Glatstein, E" uniqKey="Glatstein E">E Glatstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Strander, H" uniqKey="Strander H">H Strander</name></author><author><name sortKey="Turesson, I" uniqKey="Turesson I">I Turesson</name></author><author><name sortKey="Cavallin St Hl, E" uniqKey="Cavallin St Hl E">E Cavallin-Ståhl</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lewis, Jj" uniqKey="Lewis J">JJ Lewis</name></author><author><name sortKey="Leung, D" uniqKey="Leung D">D Leung</name></author><author><name sortKey="Heslin, M" uniqKey="Heslin M">M Heslin</name></author><author><name sortKey="Woodruff, Jm" uniqKey="Woodruff J">JM Woodruff</name></author><author><name sortKey="Brennan, Mf" uniqKey="Brennan M">MF Brennan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Singer, S" uniqKey="Singer S">S Singer</name></author><author><name sortKey="Demetri, Gd" uniqKey="Demetri G">GD Demetri</name></author><author><name sortKey="Baldini, Eh" uniqKey="Baldini E">EH Baldini</name></author><author><name sortKey="Fletcher, Cd" uniqKey="Fletcher C">CD Fletcher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Spear, Ma" uniqKey="Spear M">MA Spear</name></author><author><name sortKey="Jennings, Lc" uniqKey="Jennings L">LC Jennings</name></author><author><name sortKey="Mankin, Hj" uniqKey="Mankin H">HJ Mankin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fiore, M" uniqKey="Fiore M">M Fiore</name></author><author><name sortKey="Miceli, R" uniqKey="Miceli R">R Miceli</name></author><author><name sortKey="Mussi, C" uniqKey="Mussi C">C Mussi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hornback, Nb" uniqKey="Hornback N">NB Hornback</name></author><author><name sortKey="Shidnia, H" uniqKey="Shidnia H">H Shidnia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rubin, Bp" uniqKey="Rubin B">BP Rubin</name></author><author><name sortKey="Cooper, K" uniqKey="Cooper K">K Cooper</name></author><author><name sortKey="Fletcher, Cd" uniqKey="Fletcher C">CD Fletcher</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fein, Da" uniqKey="Fein D">DA Fein</name></author><author><name sortKey="Lee, Wr" uniqKey="Lee W">WR Lee</name></author><author><name sortKey="Lanciano, Rm" uniqKey="Lanciano R">RM Lanciano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pisters, Pw" uniqKey="Pisters P">PW Pisters</name></author><author><name sortKey="Harrison, Lb" uniqKey="Harrison L">LB Harrison</name></author><author><name sortKey="Leung, Dh" uniqKey="Leung D">DH Leung</name></author><author><name sortKey="Woodruff, Jm" uniqKey="Woodruff J">JM Woodruff</name></author><author><name sortKey="Casper, Es" uniqKey="Casper E">ES Casper</name></author><author><name sortKey="Brennan, Mf" uniqKey="Brennan M">MF Brennan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yang, Jc" uniqKey="Yang J">JC Yang</name></author><author><name sortKey="Chang, Ae" uniqKey="Chang A">AE Chang</name></author><author><name sortKey="Baker, Ar" uniqKey="Baker A">AR Baker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mundt, Aj" uniqKey="Mundt A">AJ Mundt</name></author><author><name sortKey="Awan, A" uniqKey="Awan A">A Awan</name></author><author><name sortKey="Sibley, Gs" uniqKey="Sibley G">GS Sibley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cleator, Sj" uniqKey="Cleator S">SJ Cleator</name></author><author><name sortKey="Cottrill, C" uniqKey="Cottrill C">C Cottrill</name></author><author><name sortKey="Harmer, C" uniqKey="Harmer C">C Harmer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jebsen, Nl" uniqKey="Jebsen N">NL Jebsen</name></author><author><name sortKey="Trovik, Cs" uniqKey="Trovik C">CS Trovik</name></author><author><name sortKey="Bauer, Hc" uniqKey="Bauer H">HC Bauer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dickie, Ci" uniqKey="Dickie C">CI Dickie</name></author><author><name sortKey="Griffin, Am" uniqKey="Griffin A">AM Griffin</name></author><author><name sortKey="Parent, Al" uniqKey="Parent A">AL Parent</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Delaney, Tf" uniqKey="Delaney T">TF Delaney</name></author><author><name sortKey="Kepka, L" uniqKey="Kepka L">L Kepka</name></author><author><name sortKey="Goldberg, Si" uniqKey="Goldberg S">SI Goldberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Wd" uniqKey="Kim W">WD Kim</name></author><author><name sortKey="Oh, Dh" uniqKey="Oh D">DH Oh</name></author><author><name sortKey="Ha, Sw" uniqKey="Ha S">SW Ha</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement></list><tree><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Lee, Jieun" sort="Lee, Jieun" uniqKey="Lee J" first="Jieun" last="Lee">Jieun Lee</name></region><name sortKey="Kim, Chul Yong" sort="Kim, Chul Yong" uniqKey="Kim C" first="Chul Yong" last="Kim">Chul Yong Kim</name><name sortKey="Lee, Jung Ae" sort="Lee, Jung Ae" uniqKey="Lee J" first="Jung Ae" last="Lee">Jung Ae Lee</name><name sortKey="Park, Young Je" sort="Park, Young Je" uniqKey="Park Y" first="Young Je" last="Park">Young Je Park</name><name sortKey="Rim, Chai Hong" sort="Rim, Chai Hong" uniqKey="Rim C" first="Chai Hong" last="Rim">Chai Hong Rim</name><name sortKey="Yang, Dae Sik" sort="Yang, Dae Sik" uniqKey="Yang D" first="Dae Sik" last="Yang">Dae Sik Yang</name><name sortKey="Yoon, Won Sup" sort="Yoon, Won Sup" uniqKey="Yoon W" first="Won Sup" last="Yoon">Won Sup Yoon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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