Limb sparing approach: adjuvant radiation therapy in adults with intermediate or high-grade limb soft tissue sarcoma.
BACKGROUND
Limb soft tissue sarcomas (STS) are currently treated with limb sparing surgery (LSS) followed by radiation therapy (RT).


METHODS
Between October 1994 and October 2002, 133 adult patients with intermediate or high-grade limb STS were approached by LSS+RT.


RESULTS
RT related toxicity was manageable, with a low rate of severe effects. At 4-year median follow-up, there were 48 recurrences of any type, 23 of isolated local failure, and 35 of systemic spread w/o local failure. DFS and OS were influenced by disease stage II vs I, primary site in the upper limb vs lower limb, MPNST vs other types, induction therapy vs no induction, adequate resection vs marginal resection or involved margins, and good response to induction therapy vs bad response. DFS and OS were Patient's age and sex, tumor depth, acute or late toxicity of RT, or the interval of time between the date of definitive surgery and the start of RT did not affect DFS and or OS.


CONCLUSIONS
The RT protocol is applicable in the era of complicated, expensive and time-consuming 3D therapy. Our results of LSS+RT in adults with limb HG STS are satisfactory.
Merimsky
Ofer
O
Sackler School of Medicine, Tel-Aviv University, Israel. oferm@tasmc.health.gov.il
Soyfer
Vjacheslav
V
Kovner
Felix
F
Bickels
Jacob
J
Issakov
Josephine
J
Flusser
Gideon
G
Meller
Isaac
I
Ofer
Oded
O
Kollender
Yehuda
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D012509:Sarcoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome