Late treatment-related complications in 214 patients with extremity soft-tissue sarcoma treated by surgery and postoperative radiation therapy.
BACKGROUND
We assessed the occurrence of long-bone fracture and other side effects in a group of 214 consecutive patients who underwent radical excision for soft-tissue sarcoma of the limb followed by postoperative irradiation.


METHODS
Two hundred fourteen patients underwent postoperative irradiation after radical excision of soft-tissue sarcoma of the limb; 156 (73%) received postoperative brachytherapy (BRT) plus external-beam radiation therapy (EBRT), and 58 (27%) underwent postoperative EBRT only. All patients were followed-up for a median time of 4.5 years (range 3 months to 10 years).


RESULTS
Seven patients developed bone fracture, which is considered severe morbidity; time between surgery and occurrence of fracture ranged between 10 and 72 months (average 31). Severe sclerosis with impairment of limb function was diagnosed in 5 and peripheral nerve damage in 3 patients. Wound complications were detected in 8 patients.


CONCLUSIONS
In our series, no statistically significant correlation between bone fracture and clinical features or "technical" parameters was found, but all of the patients who experienced bone fracture (7 of 7) were postmenopausal women >55 years old.
Livi
Lorenzo
L
Department of Radiation Oncology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy. l.livi@dfc.unifi.it
Santoni
Riccardo
R
Paiar
Fabiola
F
Bastiani
Paolo
P
Beltrami
Giovanni
G
Caldora
Patrizio
P
Capanna
Rodolfo
R
De Biase
Pietro
P
Detti
Beatrice
B
Fondelli
Simona
S
Meldolesi
Elisa
E
Pertici
Maurizio
M
Polli
Caterina
C
Simontacchi
Gabriele
G
Biti
Gianpaolo
G
D000328:Adult; D000368:Aged; D001918:Brachytherapy; D003131:Combined Modality Therapy; D005121:Extremities; D005260:Female; D005355:Fibrosis / Q000209:etiology; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*