Intraoperative electron-beam therapy for primary and recurrent retroperitoneal soft-tissue sarcoma.
OBJECTIVE
This study assesses the long-term outcome of patients with retroperitoneal soft-tissue sarcomas treated by maximal resection in combination with intraoperative electron-beam therapy (IOERT) and postoperative external-beam radiotherapy.


METHODS
From 1991 to 2004, 67 patients were treated with curative intent for primary (n = 26) or recurrent (n = 41) retroperitoneal soft-tissue sarcoma. All patients underwent maximal resection in combination with IOERT (mean dose, 15 Gy), 45 patients underwent additional postoperative EBRT, and 20 patients were previously irradiated.


RESULTS
The 5-year actuarial overall survival (OS), disease-free survival, local control (LC), and freedom from metastatic disease of all patients was 64%, 28%, 40%, and 50%, respectively. The 5-year LC inside the IOERT field was 72%. For patients who completed IOERT and EBRT after R0-resection 5-year and 10-year OS was 80%, and 5-year and 10-year LC was 100%. Only 1 of the 21 patients after R0-resection and only 8 of 34 patients after R1-resection compared with 9 of 12 patients after R2-resection experienced inside IOERT-field relapse. Grade II or higher late complications were seen in 21% of the patients, but only 2 patients required surgical intervention because of late complications.


CONCLUSIONS
In selected patients, IOERT results in excellent local control and survival, with acceptable morbidity.
Krempien
Robert
R
Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany. robert_krempien@med.uni-heidelberg.de
Roeder
Falk
F
Oertel
Susanne
S
Weitz
Jürgen
J
Hensley
Frank W
FW
Timke
Carmen
C
Funk
Angela
A
Lindel
Katja
K
Harms
Wolfgang
W
Buchler
Markus W
MW
Debus
Jürgen
J
Treiber
Martina
M