title: Clinical outcomes of tissue expanders on adjuvant radiotherapy of resected retroperitoneal sarcoma.
abstract: We investigated the efficacy and safety of a tissue expander (TE) for adjuvant radiotherapy (RT) of resected retroperitoneal sarcoma (RPS).This study was conducted with 37 patients with RPS who received resection with or without TE insertion followed by RT from August 2006 to June 2012 at Samsung Medical Center. Among the 37 patients, TE was inserted in 19. The quality of TE insertion was evaluated according to the correlation of clinical target volume and retroperitoneal surface volume covered by TE and was defined as follows: excellent, ≥85%; good, 70% to 85%; fair, 50% to 70%; and poor, <50%. The median follow-up period after surgery was 47.9 months (range, 5.5-85.5 months).The quality of TE insertion was excellent in 7 (36.8%), good in 5 (26.3%), fair in 4 (21.0%), and poor in 3 (16.7%) patients. A significantly higher biologically equivalent dose (BED, α/β = 10) was used in patients who had TE insertion (median, 64.8 vs. 60.0 Gy, P = 0.01). Local control was 39.7%, and overall survival was 76.4% at 5 years. Local control was significantly higher in patients who received ≥65 Gy of BED, 100.0% in contrast to 22.8% (P = 0.01). One patient with a history of multiple tumor resections showed abdominal infection with duodenal perforation of uncertain cause but had the potential of being related to TE and/or RT. Otherwise there were no ≥grade III acute or late toxicities.TE for adjuvant RT in RPS is feasible for delivering a higher RT dose with acceptable toxicity.
authors.affiliation: Department of Radiation Oncology, Samsung Medical Center Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Department of Radiation Oncology, Sheikh Khalifa Specialist Hospital, Ras Al Khaimah, United Arab Emirates Department of Surgery, Samsung Medical Center, Seoul, Republic of Korea.
authors.forename: Jeong Il
authors.initials: JI
authors.lastname: Yu
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Lim
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Park
authors.forename: Heerim
authors.initials: H
authors.lastname: Nam
authors.forename: Bo Kyoung
authors.initials: BK
authors.lastname: Kim
authors.forename: Sung-Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jae Berm
authors.initials: JB
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012186:Retroperitoneal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012509:Sarcoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D015625:Tissue Expansion Devices; D016896:Treatment Outcome