title: Neoadjuvant chemoradiation (modified Eilber protocol) versus adjuvant radiotherapy in the treatment of extremity soft tissue sarcoma.
abstract: BACKGROUND
  Local control for extremity soft tissue sarcomas (STS) requires surgery combined with radiotherapy, usually given pre-operatively or post-operatively. The modified Eilber protocol, a neoadjuvant chemoradiation regimen, has been reported with excellent local control rates. This retrospective single-centre study compared outcomes for patients treated with the modified Eilber protocol with those treated with standard adjuvant radiotherapy.
  
  
  METHODS
  Patients with a diagnosis of extremity STS were retrospectively reviewed from the Prince of Wales Hospital Sarcoma Database from 1995 to 2012. Sixty-three patients underwent curative surgery with either neoadjuvant Eilber chemoradiotherapy (Eilber) or adjuvant radiotherapy (Adjuvant).
  
  
  RESULTS
  Twenty-nine patients were treated with modified Eilber protocol. Thirty-four patients received adjuvant radiotherapy. Three patients (10%) in the Eilber group and five patients (15%) in the Adjuvant group developed local recurrence (P = 0.87). Major acute wound complications were noted in four patients in each group (P = 0.55). One patient (3.4%) in the Eilber group developed Grade 3 or 4 late toxicities after 1 year compared with nine patients (27%) in the Adjuvant group (P = 0.02).
  
  
  CONCLUSIONS
  Neoadjuvant chemoradiation (Eilber protocol) provided similar rates of local control when compared with adjuvant radiotherapy. Acute wound complication rates were similar but there was less severe late toxicity in the Eilber group.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Lehane
authors.affiliation: Department of Radiation Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Frederick
authors.initials: F
authors.lastname: Ho
authors.affiliation: Department of Radiation Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.|University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Thompson
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.|University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Links
authors.affiliation: University of New South Wales, Sydney, New South Wales, Australia.|Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Craig
authors.initials: C
authors.lastname: Lewis
authors.affiliation: Department of Radiation Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.|University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Smee
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Parasyn
authors.affiliation: Department of Medical Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Friedlander
authors.affiliation: Department of Radiation Oncology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Williams
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia.|University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Phil
authors.initials: P
authors.lastname: Crowe
mesh_terms: D059248:Chemoradiotherapy / Q000379:methods*; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000532:radiotherapy / Q000628:therapy*
keywords: combined modality therapy; limb-sparing surgery; radiotherapy; soft tissue sarcoma; treatment outcome