The role of surgery and radiotherapy in treatment of soft tissue sarcomas of the head and neck region: review of 30 cases.
BACKGROUND
Thirty adult patients with head and neck soft tissue sarcoma (HNSTS) treated between 1987 and 2000 were retrospectively analysed.


METHODS
The most frequent histopathological subtypes were chondrosarcomas (27%) and malignant fibrous histiocytoma (20%). The surgical resection was performed in 25 of the 30 patients (83%). Twenty-three patients in the surgical resection arm received postoperative radiotherapy.


RESULTS
Five-year local control rates for patients with negative surgical margins (n=9), microscopically positive disease (n=10), gross residual disease (n=6) and inoperable cases (n=5) were 64, 70, 20 and 0%, respectively. However, there was no significant difference in local control between patients with negative or microscopically positive disease who received postoperative radiotherapy (71 vs. 70%). The patients who received doses>or=60 Gy had significantly higher local control rates than the ones who received doses lower than 60 Gy (p=0.048). The local control rates were lower in patients with grade 2-3 tumours when compared with grade 1 tumours (44 vs. 83%). The median overall survival of whole group was 31 months. Median survivals of patients receiving both surgery and radiotherapy with negative and microscopically positive margins were significantly better than patients who were not treated with surgery (34.8 and 36 vs. 13.3 months).


CONCLUSIONS
Our results confirm that the optimal treatment of HNSTSs is complete surgical excision, and that postoperative adjuvant radiotherapy clearly improves local control.
Fayda
Merdan
M
Kocaeli University, Faculty of Medicine, Department of Radiation Oncology, Turkey. merdanfayda@yahoo.com
Aksu
Gorkem
G
Yaman Agaoglu
Fulya
F
Karadeniz
Ahmet
A
Darendeliler
Emin
E
Altun
Musa
M
Hafiz
Gunter
G
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002813:Chondrosarcoma / Q000532:radiotherapy / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D051677:Histiocytoma, Malignant Fibrous / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018365:Neoplasm, Residual / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000473:pathology; D009669:Nose Neoplasms / Q000532:radiotherapy / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D055815:Young Adult