Radiation therapy in addition to gross total resection of retroperitoneal sarcoma results in prolonged survival: results from a single institutional study.
Purpose. Typical treatment of retroperitoneal sarcomas (RPSs) is surgery with or without radiation therapy for localized disease. With surgery alone, local failure rates are as high as 90%; this led to radiation therapy playing an important role in the treatment of RPSs. Methods. Thirty-one patients with retroperitoneal sarcoma treated with gross total resection and radiation therapy make up this retrospective analysis. Nineteen were treated preoperatively and 12 postoperatively (median dose, 59.4 Gy)-sixteen also received intraoperative radiation therapy (IORT) (median dose, 11 Gy). Patients were followed with stringent regimens, including frequent CT scans of the chest, abdomen, and pelvis. Results. With a median follow-up of 19 months (range 1-66 months), the 2-year overall survival (OS) rate is 70% (median, 52 months). The 2-year locoregional control (LRC) rate is 77% (median, 61.6 months). The 2-year distant disease free survival (DDFS) rate is 70% (median not reached). There were no differences in radiation-related acute and late toxicities among patients treated pre- versus postoperatively, whether with or without IORT. Conclusions. Compared to surgery alone, neoadjuvant or adjuvant radiation therapy offers patients with RPS an excellent chance for long-term LRC, DDS, and OS. The integration of modern treatment planning for external beam radiation therapy and IORT allows for higher doses to be delivered with acceptable toxicities.
Zagar
Timothy M
TM
Department of Radiation Oncology, Case Medical Center, University Hospitals, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Shenk
Robert R
RR
Kim
Julian A
JA
Harpp
Deb
D
Kunos
Charles A
CA
Abdul-Karim
Fadi W
FW
Chen
William C
WC
Seo
Yuji
Y
Kinsella
Timothy J
TJ