title: Definitive radiotherapy for unresectable pediatric and young adult nonrhabdomyosarcoma soft tissue sarcoma.
abstract: BACKGROUND
  Few published articles describe outcomes following definitive radiation for unresectable pediatric and young adult nonrhabdomyosarcoma soft tissue sarcoma (NRSTS). The purpose of this study is to evaluate the prognostic factors, outcomes, and complications in patients age 30 years or younger with NRSTS treated at the University of Florida from 1973 to 2002.
  
  
  METHODS
  Nineteen pediatric and young adult patients with NRSTS were treated with radiotherapy after biopsy. Thirteen patients had high-grade tumors. The median age at radiotherapy was 19.6 years; the median dose was 55.2 Gy. Twelve patients received chemotherapy. Prognostic factors for local recurrence, distant metastases, and survival were analyzed.
  
  
  RESULTS
  Median follow-up was 2.6 years. The 5-year local-control rate was 40%. Nine out of 13 local failures occurred in the absence of metastatic disease. All patients with local failures died of their cancer, and 8 patients died without evidence of distant metastases. There was a trend toward improved local control with low/intermediate-grade tumors. Freedom from distant metastases at 5 years was 68%. Fourteen patients died of their disease. The 5-year overall survival was 37%. There was one grade 4 complication based on NCI Common Terminology Criteria for Adverse Events version 3.
  
  
  CONCLUSIONS
  Young patients with unresectable NRSTS have a poor outcome thereby justifying current study efforts focused on treatment intensification. By demonstrating that all patients with local recurrence died of disease and more than half of these deaths occurred in the absence of distant spread, these results suggests that improved means of local control may translate into improvement in survival.
authors.affiliation: Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA.
authors.forename: Kristy B
authors.initials: KB
authors.lastname: Smith
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Indelicato
authors.forename: Jacquelyn A
authors.initials: JA
authors.lastname: Knapik
authors.forename: Christopher
authors.initials: C
authors.lastname: Morris
authors.forename: Jessica
authors.initials: J
authors.lastname: Kirwan
authors.forename: Robert A
authors.initials: RA
authors.lastname: Zlotecki
authors.forename: Mark T
authors.initials: MT
authors.lastname: Scarborough
authors.forename: Charles Parker
authors.initials: CP
authors.lastname: Gibbs
authors.forename: Robert B
authors.initials: RB
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000532:radiotherapy*; D012983:Soft Tissue Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult