Re-irradiation of soft-tissue sarcoma.
Re-irradiation for local recurrence of malignancy after radical radiotherapy is of proven benefit at head and neck sites but has seldom been used elsewhere. This paper reports a series of 10 patients re-irradiated with external-beam techniques for local recurrence of soft-tissue sarcoma of the limb and limb girdle following initial limb conserving management with surgery and radiotherapy (dose range 33-60 Gy). Median survival was 14 months following re-treatment. Two cases received treatment with high-energy electrons and the rest with megavoltage photons. Five patients re-treated with radical intent (dose range 40-60 Gy) had a median survival of 36 months and median recurrence-free survival of 16 months. All five patients treated palliatively (dose range 12-50 Gy) have died, although two demonstrated local control until death. Acute reactions were not severe. Radionecrosis was seen in one patient who was re-irradiated twice (total dose 145 Gy) and subsequently required amputation. One other case required amputation for persistent local disease, but in the remaining eight, limb conservation was achieved. Re-irradiation of soft-tissue offers good local control and may avoid amputation.
Sarcoma Unit, Royal Marsden Hospital, London, UK.
J D
JD
Graham
M H
MH
Robinson
C L
CL
Harmer
D000328:Adult; D000368:Aged; D001132:Arm; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods; D011379:Prognosis; D011882:Radiotherapy, High-Energy; D012509:Sarcoma / Q000532:radiotherapy*; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy*; D013848:Thigh