title: Radiation therapy and conservative surgery for soft tissue sarcomas of the extremities, torso and head and neck.
abstract: 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. with initially inoperable tumor; surgical margins were negative in 5 and positive in 2 pts. Twenty-six pts. (58%) had tumor greater than or equal to 5 cm (5-24) and 19 (42%) less than 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.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Radiotherapy Division, Centro di Riferimento Oncologico (C.R.O.), Aviano, Italy.
authors.forename: A
authors.initials: A
authors.lastname: De Paoli
authors.forename: G
authors.initials: G
authors.lastname: Bertola
authors.forename: G
authors.initials: G
authors.lastname: Boz
authors.forename: F
authors.initials: F
authors.lastname: Gherlinzoni
authors.forename: S
authors.initials: S
authors.lastname: Frustaci
authors.forename: G
authors.initials: G
authors.lastname: Fumo
authors.forename: R
authors.initials: R
authors.lastname: Innocente
authors.forename: M G
authors.initials: MG
authors.lastname: Trovò
authors.forename: C
authors.initials: C
authors.lastname: Rossi
authors.forename: A
authors.initials: A
authors.lastname: Carbone
mesh_terms: D000328:Adult; D000368:Aged; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D013514:Surgical Procedures, Operative / Q000379:methods; D013899:Thoracic Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*