Preliminary results from a prospective study using limited margin radiotherapy in pediatric and young adult patients with high-grade nonrhabdomyosarcoma soft-tissue sarcoma.
OBJECTIVE
To demonstrate the safety and efficacy of limited margin radiotherapy in the local control of pediatric and young adult patients with high-grade nonrhabdomyosarcoma soft tissue sarcoma (NRSTS).


METHODS
Pediatric patients with high-grade NRSTS requiring radiation were treated on an institutional review board approved prospective institutional study of conformal/intensity-modulated/interstitial brachytherapy using a 2-cm anatomically constrained margin.


RESULTS
A total of 32 patients (median age, 15.3 years; range, 2-22 years) received adjuvant (27 patients) or definitive (5 patients) irradiation. With a median follow-up of 32 months, the 3-year cumulative incidence of local failure was 3.7% for patients undergoing irradiation after surgical resection. Four patients experienced local failure; the mean dose to the volume of recurrence was >or=97% of the prescribed dose.


CONCLUSIONS
Delivery of limited margin radiotherapy using external beam or brachytherapy provides a high rate of local tumor control without marginal failure. Further follow-up is required to determine whether normal tissue effects are minimized using this approach.
Krasin
Matthew J
MJ
Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN 38105, USA. matthew.krasin@stjude.org
Davidoff
Andrew M
AM
Xiong
Xiaoping
X
Wu
Shengjie
S
Hua
Chia-Ho
CH
Navid
Fariba
F
Rodriguez-Galindo
Carlos
C
Rao
Bhaskar N
BN
Hoth
Kelly A
KA
Neel
Michael D
MD
Merchant
Thomas E
TE
Kun
Larry E
LE
Spunt
Sheri L
SL
D000293:Adolescent; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods; D012509:Sarcoma / Q000473:pathology / Q000532:radiotherapy*; D017211:Treatment Failure; D047368:Tumor Burden; D055815:Young Adult