The George Edelstyn memorial lecture: radiation in the management of malignant soft tissue tumours.
Consistently good results in patients with sarcoma of soft tissue are more likely if they are managed by a sarcoma team in a centre which sees large numbers of such patients. The results of treatment of 258 patients at Massachusetts General Hospital (1971-1986) by radiation with surgery are described. The rationale for combining radiation and surgery is considered. Local control rates (actuarial at 5 years) are 86% and 91% for radiation administered postoperatively and pre-operatively respectively. In the most recent period, 1980-1986, the results were 92% and 97% respectively (63 and 82 patients). Preoperative radiation treatment is judged to be more effective than postoperative radiation, especially for the larger sarcomas. Currently, several strategies are being employed in the management of patients with sarcoma of soft tissues: radical ablative surgery, surgery combined with radiation (pre- or postoperatively, and or intra-operatively), and surgery combined with radiation and intra-arterial chemotherapy. High local control rates are being achieved by these diverse treatment methods. There is an obvious need to assess the cosmetic and functional results achieved by the different treatment methods so as to determine the most clinically effective approach. Chemotherapy in patients with stage M0 disease has not been proven to yield a clinical gain.
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Department of Radiation Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston 02114.
D003131:Combined Modality Therapy; D006801:Humans; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery