title: Long-term clinical outcome of patients with soft tissue sarcomas treated with limb-sparing surgery and postoperative radiotherapy.
abstract: BACKGROUND
  To evaluate long-term local control, survival, radiation side effects and functional outcome after limb-sparing surgery followed by postoperative radiotherapy (RT) for soft tissue sarcoma (STS).
  
  
  METHODS
  Between 1995 and 2010, 118 patients with STS of an extremity were treated with limb-sparing surgery and postoperative RT. Follow-up was complete for all patients. Acute and late radiation related toxicities were scored using CTCAE v4.0.
  
  
  RESULTS
  Median follow-up was 93 months. RT dose was 60 Gy in 92.4% of the patients; 5.1% received 66 Gy; 2.5% 50-56 Gy. Actuarial local recurrence rates at five and 10 years were 9% and 12%. Five- and 10-year overall survival rates were 69% and 51%. Acute radiation toxicities occurred in 91% of the patients; 19% were grade 3, 2% grade 4. Late radiation toxicities were reported in 71% of the patients: 50% grade 1, 18% grade 2, and 3% grade 3. Limb and joint function after treatment were good, 19% having mild limitation of motion, 1.5% moderate, and 2.5% severe limitations.
  
  
  CONCLUSIONS
  Limb-sparing surgery with 60 Gy postoperative radiotherapy for patients with STS provides excellent local control and high survival rates with acceptable toxicity and functional outcomes.
authors.affiliation: Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands. C.L.Creutzberg@lumc.nl
authors.forename: Joeke M
authors.initials: JM
authors.lastname: Felderhof
authors.forename: Carien L
authors.initials: CL
authors.lastname: Creutzberg
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Remi A
authors.initials: RA
authors.lastname: Nout
authors.forename: Judith V M G
authors.initials: JV
authors.lastname: Bovée
authors.forename: P D Sander
authors.initials: PD
authors.lastname: Dijkstra
authors.forename: Henk H
authors.initials: HH
authors.lastname: Hartgrink
authors.forename: Corrie A M
authors.initials: CA
authors.lastname: Marijnen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005121:Extremities / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D011184:Postoperative Period; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D012720:Severity of Illness Index; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data; D016896:Treatment Outcome