title: Late treatment-related complications in 214 patients with extremity soft-tissue sarcoma treated by surgery and postoperative radiation therapy.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy. l.livi@dfc.unifi.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Santoni
authors.forename: Fabiola
authors.initials: F
authors.lastname: Paiar
authors.forename: Paolo
authors.initials: P
authors.lastname: Bastiani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Beltrami
authors.forename: Patrizio
authors.initials: P
authors.lastname: Caldora
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Capanna
authors.forename: Pietro
authors.initials: P
authors.lastname: De Biase
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.forename: Simona
authors.initials: S
authors.lastname: Fondelli
authors.forename: Elisa
authors.initials: E
authors.lastname: Meldolesi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pertici
authors.forename: Caterina
authors.initials: C
authors.lastname: Polli
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simontacchi
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Biti
mesh_terms: 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*