Intraoperative electron boost radiation followed by moderate doses of external beam radiotherapy in limb-sparing treatment of patients with extremity soft-tissue sarcoma.
OBJECTIVE
To analyze long-term prognosis and morbidity after limb-sparing treatment of patients with extremity soft-tissue sarcoma, with intraoperative electron boost radiotherapy (IOERT) followed by a moderate dose of external beam radiotherapy (EBRT).


METHODS
A total of 153 patients who were treated in a single center from 1991 to 2004 were evaluated. Median IOERT dose was 15 Gy, mean EBRT dose 43 Gy (range, 40-50.4 Gy) in conventional fractionation (1.8-2 Gy). Median duration of follow-up was 33 months. Acute toxicity was assessed with Common Toxicity Criteria; late toxic effects were scored according to European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria.


RESULTS
Five-year overall survival and 5-year local control rates were 77% and 78%, respectively. Whereas tumor size, patient age, and EBRT dose did not significantly affect outcome, resection status and grading were significant for survival; resection status and IOERT dose were significant for local control. Extremity salvage until death or time of follow-up was achieved in 90% of our patients, 86% of whom showed excellent limb function without impairment in activities of daily life. Acute toxicity Grade 2-4 was observed in 23% and late toxicity Grade 2-4 in 17% of patients.


CONCLUSIONS
Treatment with IOERT combined with moderate doses of external beam irradiation yields high local control and extremity preservation rates in resected extremity soft-tissue sarcoma.
Oertel
Susanne
S
Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany.
Treiber
Martina
M
Zahlten-Hinguranage
Angelika
A
Eichin
Steffen
S
Roeder
Falk
F
Funk
Angela
A
Hensley
Frank W
FW
Timke
Carmen
C
Niethammer
Andreas G
AG
Huber
Peter E
PE
Weitz
Juergen
J
Eble
Micheal J
MJ
Buchler
Markus W
MW
Bernd
Ludger
L
Debus
Jürgen
J
Krempien
Robert C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004583:Electrons / Q000627:therapeutic use; D005121:Extremities; D005260:Female; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011878:Radiotherapy / Q000379:methods; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D015996:Survival Rate