TY - JOUR
T1 - The role of radiotherapy in the treatment of superficial soft-tissue sarcomas
AU - Fujiwara, T.
AU - Tsuda, Y.
AU - Nail, L. R.Le
AU - Evans, S.
AU - Gregory, J.
AU - Tillman, R.
AU - Abudu, A.
N1 - Funding Information:
This work was supported by a grant-in-aid for overseas research fellowships from the Uehara Memorial Foundation (TF; 201640179).
Publisher Copyright:
© 2020 British Editorial Society of Bone and Joint Surgery. All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - The existing clinical guidelines do not describe a clear indication for adjuvant radiotherapy (RT) in the treatment of superficial soft tissue sarcomas (STSs). We aimed to determine the efficacy of adjuvant RT for superficial STSs. Methods We retrospectively studied 304 patients with superficial STS of the limbs and trunk who underwent surgical resection at a tertiary sarcoma centre. The efficacy of RT was investigated according to the tumour size and grade: group 1, . 5 cm, low grade; group 2, . 5cm, high grade; group 3, > 5 cm, low grade; group 4, > 5 cm, high grade. Results The five- and ten-year local recurrence-free survival (LRFS) for all patients was 88% and 81%, respectively. While the efficacy of adjuvant RT was not proven in local control of all patients (five-year LRFS; RT+, 90% versus RT-, 83%; p = 0.074), the LRFS was significantly improved by adjuvant RT in group 2 (five-year LRFS; RT+, 96% versus RT-, 82%; p = 0.019), and group 4 (five-year LRFS; RT+, 87% versus RT-, 73%; p = 0.027). In groups 2 and 4, adjuvant RT significantly reduced the LR risk if the resection margin was clear but less than 5 mm; the LR rate was 7% with adjuvant RT compared with 26% with surgery alone (p = 0.003). There was no statistical relationship with the use of adjuvant RT and survival in every group. Conclusion Adjuvant RT reduces the risk of local recurrence in patients with superficial high-grade STS regardless of tumour size, especially when resection margin is less than 5 mm.
AB - The existing clinical guidelines do not describe a clear indication for adjuvant radiotherapy (RT) in the treatment of superficial soft tissue sarcomas (STSs). We aimed to determine the efficacy of adjuvant RT for superficial STSs. Methods We retrospectively studied 304 patients with superficial STS of the limbs and trunk who underwent surgical resection at a tertiary sarcoma centre. The efficacy of RT was investigated according to the tumour size and grade: group 1, . 5 cm, low grade; group 2, . 5cm, high grade; group 3, > 5 cm, low grade; group 4, > 5 cm, high grade. Results The five- and ten-year local recurrence-free survival (LRFS) for all patients was 88% and 81%, respectively. While the efficacy of adjuvant RT was not proven in local control of all patients (five-year LRFS; RT+, 90% versus RT-, 83%; p = 0.074), the LRFS was significantly improved by adjuvant RT in group 2 (five-year LRFS; RT+, 96% versus RT-, 82%; p = 0.019), and group 4 (five-year LRFS; RT+, 87% versus RT-, 73%; p = 0.027). In groups 2 and 4, adjuvant RT significantly reduced the LR risk if the resection margin was clear but less than 5 mm; the LR rate was 7% with adjuvant RT compared with 26% with surgery alone (p = 0.003). There was no statistical relationship with the use of adjuvant RT and survival in every group. Conclusion Adjuvant RT reduces the risk of local recurrence in patients with superficial high-grade STS regardless of tumour size, especially when resection margin is less than 5 mm.
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U2 - 10.1302/0301-620X.102B8.BJJ-2020-0043.R1
DO - 10.1302/0301-620X.102B8.BJJ-2020-0043.R1
M3 - Article
C2 - 32731827
AN - SCOPUS:85088908708
VL - 102
SP - 1088
EP - 1094
JO - Bone and Joint Journal
JF - Bone and Joint Journal
SN - 2049-4394
IS - 8
ER -