title: Radiation therapy in addition to gross total resection of retroperitoneal sarcoma results in prolonged survival: results from a single institutional study.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Case Medical Center, University Hospitals, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Zagar
authors.forename: Robert R
authors.initials: RR
authors.lastname: Shenk
authors.forename: Julian A
authors.initials: JA
authors.lastname: Kim
authors.forename: Deb
authors.initials: D
authors.lastname: Harpp
authors.forename: Charles A
authors.initials: CA
authors.lastname: Kunos
authors.forename: Fadi W
authors.initials: FW
authors.lastname: Abdul-Karim
authors.forename: William C
authors.initials: WC
authors.lastname: Chen
authors.forename: Yuji
authors.initials: Y
authors.lastname: Seo
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Kinsella