title: Neoadjuvant treatment of soft tissue sarcoma.
abstract: OBJECTIVE
  The aim of this study was to evaluate disease-free survival (DFS), overall survival and toxicity of patients who underwent preoperative therapy for soft tissue sarcoma.
  
  
  METHODS
  The data of 38 consecutive patients affected by soft tissue sarcoma were retrospectively analysed. Six (15.8 %) patients were treated only with neoadjuvant radiotherapy, and 32 (84.2 %) with neoadjuvant chemo-radiation therapy. Surgery was performed within 4-6 weeks after the completion of neoadjuvant treatment.
  
  
  RESULTS
  Median follow-up was 4.9 years (range 1-13.7 years). All patients received preoperative external beam radiotherapy (RT). Most patients (84.2 %) underwent neoadjuvant chemotherapy treatment associated with radiotherapy. After neoadjuvant treatment, the majority of patients underwent wide excision (32 out of 38) and five patients had marginal surgery; only one patient underwent amputation. Local recurrence was observed in only two patients (5.2 %). Fourteen (36.8 %) patients experienced metastatic relapse. At the time of our analysis 13 patients (34.2 %) had died due to metastatic spread of the disease. In our series, DFS in relation to distant metastases (DM) showed a significant result for lower limb involvement (p = 0.038) and marginal excision (p = 0.024), both predictors of a worse DFS, histology was statistically significant although it was not possible to evaluate the risk for specific histology due to the small number of events in the different subtypes.
  
  
  CONCLUSIONS
  The results obtained from our study are encouraging with regard to the feasibility and efficacy of preoperative RT in the treatment of soft tissue sarcoma in view of the results obtained in terms of local control, limb sparing and safety.
authors.affiliation: Radiotherapy Unit, University of Florence, Largo Brambilla 1, 50134, Florence, Italy, daniela.greto@gmail.com.
authors.forename: Daniela
authors.initials: D
authors.lastname: Greto
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livi
authors.forename: Calogero
authors.initials: C
authors.lastname: Saieva
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Bonomo
authors.forename: Icro
authors.initials: I
authors.lastname: Meattini
authors.forename: Mauro
authors.initials: M
authors.lastname: Loi
authors.forename: Lucia
authors.initials: L
authors.lastname: Di Brina
authors.forename: Giovanni
authors.initials: G
authors.lastname: Beltrami
authors.forename: Domenico
authors.initials: D
authors.lastname: Campanacci
authors.forename: Guido
authors.initials: G
authors.lastname: Scoccianti
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Capanna
authors.forename: Monica
authors.initials: M
authors.lastname: Mangoni
authors.forename: Fabiola
authors.initials: F
authors.lastname: Paiar
authors.forename: Alessandro
authors.initials: A
authors.lastname: Franchi
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Biti
mesh_terms: D000328:Adult; D000368:Aged; D003952:Diagnostic Imaging; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*