Intraoperative electron radiation therapy combined with external beam radiation therapy and limb sparing surgery in extremity soft tissue sarcoma: a retrospective single center analysis of 183 cases

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• 作者：Falk Roeder^a ; ^b ; ^c ; ^d ; ¹ ; ^{Falk.Roeder@med.uni-muenchen.de" class="auth_mail" title="E-mail the corresponding author} ; Burkhard Lehner^e ; ^{Burkhard.Lehner@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Ladan Saleh-Ebrahimi^b ; ^d ; ¹ ; ^{Ladan.SalehEbrahimi@med.uni-muenchen.de" class="auth_mail" title="E-mail the corresponding author} ; Frank W. Hensley^c ; ¹ ; ^{Frank.Hensley@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Alexis Ulrich^f ; ^{Alexis.Ulrich@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Ingo Alldinger^f ; ^{Ingo.Alldinger@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Gunhild Mechtersheimer^g ; ^{Gunhild.Mechtersheimer@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Peter E. Huber^a ; ^c ; ^{p.huber@dkfz.de" class="auth_mail" title="E-mail the corresponding author} ; Robert Krempien^a ; ^h ; ¹ ; ^{Robert.krempien@helios-kliniken.de" class="auth_mail" title="E-mail the corresponding author} ; Marc Bischof^a ; ⁱ ; ¹ ; ^{Marc.Bischof@slk-kliniken.de" class="auth_mail" title="E-mail the corresponding author} ; Juergen Debus^a ; ^b ; ^{Juergen.Debus@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Matthias Uhl^a ; ^{Matthias.Uhl@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Extremity ; Soft tissue sarcoma ; IOERT ; EBRT ; Limb-sparing surgery
• 刊名：Radiotherapy and Oncology
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：119
• 期：1
• 页码：22-29
• 全文大小：459 K

文摘

To report our experience with limb-sparing surgery, IOERT and EBRT in extremity STS.

Materials and methods

183 patients were retrospectively analyzed. 78% presented in primary situation, with 80% located in the lower limb. Stage at presentation was: I: 6%, IIa: 25%, IIb: 21%, III: 42%, IV: 7%. The majority showed high-grade lesions (grade 1: 5%, 2: 31%, 3: 64%). IOERT was applied to the tumor bed (median 15 Gy) and preceded (9%) or followed (91%) by EBRT (median 45 Gy) in all patients.

Results

Median follow-up was 64 months (78 months in survivors). Surgery was complete in 68%, while 32% had microscopic residual disease. 5- and 10-year-LC was 86% and 84%, respectively. LC was significantly higher in primary compared to recurrent disease and tended to be higher after complete resection. Estimated 5- and 10-year-DC was 68% and 66%, while corresponding OS was 77% and 66%, respectively. OS was significantly affected by grading and stage. Severe postoperative complications and late toxicities were observed in 19% and 20%, respectively. Limb-preservation rate was 95% with good function in 83%.

Conclusions

Combination of limb-sparing surgery, IOERT and EBRT achieved encouraging LC and OS in this unfavorable patient group with acceptable postoperative complications and low rates of late toxicities resulting in a high limb-preservation rate and good functional outcome.