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Radiotherapy to Improve Local Control Regardless of Surgical Margin and Malignancy Grade in Extremity and Trunk Wall Soft Tissue Sarcoma: A Scandinavian Sarcoma Group Study

Abstract

Purpose: Adjuvant radiotherapy has during the past decades become increasingly used in the treatment of localized soft tissue sarcoma. We evaluated the effect of radiotherapy (RT) on local recurrence rates (LRRs) in Scandinavia between 1986 and 2005. Methods and Materials: A total of 1,093 adult patients with extremity or trunk wall soft tissue sarcoma treated at four Scandinavian sarcoma centers were stratified according to the treatment period (1986-1991, 1992-1997, and 1998-2005). The use of adjuvant RT, quality of the surgical margin, interval between surgery and RT, and LRR were analyzed. The median follow-up was 5 years. Results: The use of RT (77% treated postoperatively) increased from 28% to 53%, and the 5-year LRR decreased from 27% to 15%. The rate of wide surgical margins did not increase. The risk factors for local recurrence were histologic high-grade malignancy (hazard ratio [HR], 5), an intralesional (HR, 6) or marginal (HR, 3) surgical margin, and no RT (HR, 3). The effect of RT on the LRR was also significant after a wide margin resection and in low-grade malignant tumors. The LRR was the same after preoperative and postoperative RT. The median interval from surgery to the start of RT was 7 weeks, and  More>>
Authors:
Jebsen, Nina L; [1]  Department of Oncology, Haukeland University Hospital, Bergen (Norway)], E-mail: njeb@helse-bergen.no; Trovik, Clement S; [2]  Department of Orthopedics, Haukeland University Hospital, Bergen (Norway)]; Bauer, Henrik C.F.; [3]  Rydholm, Anders; [4]  Monge, Odd R; [2]  Hall, Kirsten Sundby; [5]  Alvegard, Thor; [6]  Bruland, Oyvind S; [5]  University of Oslo, Faculty Group, Norwegian Radium Hospital, Oslo (Norway)]
  1. Department of Surgical Sciences, University of Bergen Faculty of Medicine, Bergen (Norway)
  2. Department of Oncology, Haukeland University Hospital, Bergen (Norway)
  3. Department of Orthopedics, Karolinska Hospital, Stockholm (Sweden)
  4. Department of Orthopedics, Lund University Hospital, Lund (Sweden)
  5. Cancer Clinic, Rikshospitalet-Radiumhospitalet Medical Center, Oslo (Norway)
  6. Department of Cancer Epidemiology, Lund University Hospital, Lund (Sweden)
Publication Date:
Jul 15, 2008
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 71; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2007.11.023; PII: S0360-3016(07)04586-5; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; HAZARDS; PATIENTS; RADIOTHERAPY; SARCOMAS; SURGERY
OSTI ID:
21124368
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US08R2611007072
Availability:
Available from http://dx.doi.org/10.1016/j.ijrobp.2007.11.023;INIS
Submitting Site:
INIS
Size:
page(s) 1196-1203
Announcement Date:
Feb 26, 2009

Citation Formats

Jebsen, Nina L, Department of Oncology, Haukeland University Hospital, Bergen (Norway)], E-mail: njeb@helse-bergen.no, Trovik, Clement S, Department of Orthopedics, Haukeland University Hospital, Bergen (Norway)], Bauer, Henrik C.F., Rydholm, Anders, Monge, Odd R, Hall, Kirsten Sundby, Alvegard, Thor, Bruland, Oyvind S, and University of Oslo, Faculty Group, Norwegian Radium Hospital, Oslo (Norway)]. Radiotherapy to Improve Local Control Regardless of Surgical Margin and Malignancy Grade in Extremity and Trunk Wall Soft Tissue Sarcoma: A Scandinavian Sarcoma Group Study. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2007.11.023.
Jebsen, Nina L, Department of Oncology, Haukeland University Hospital, Bergen (Norway)], E-mail: njeb@helse-bergen.no, Trovik, Clement S, Department of Orthopedics, Haukeland University Hospital, Bergen (Norway)], Bauer, Henrik C.F., Rydholm, Anders, Monge, Odd R, Hall, Kirsten Sundby, Alvegard, Thor, Bruland, Oyvind S, & University of Oslo, Faculty Group, Norwegian Radium Hospital, Oslo (Norway)]. Radiotherapy to Improve Local Control Regardless of Surgical Margin and Malignancy Grade in Extremity and Trunk Wall Soft Tissue Sarcoma: A Scandinavian Sarcoma Group Study. United States. https://doi.org/10.1016/j.ijrobp.2007.11.023
Jebsen, Nina L, Department of Oncology, Haukeland University Hospital, Bergen (Norway)], E-mail: njeb@helse-bergen.no, Trovik, Clement S, Department of Orthopedics, Haukeland University Hospital, Bergen (Norway)], Bauer, Henrik C.F., Rydholm, Anders, Monge, Odd R, Hall, Kirsten Sundby, Alvegard, Thor, Bruland, Oyvind S, and University of Oslo, Faculty Group, Norwegian Radium Hospital, Oslo (Norway)]. 2008. "Radiotherapy to Improve Local Control Regardless of Surgical Margin and Malignancy Grade in Extremity and Trunk Wall Soft Tissue Sarcoma: A Scandinavian Sarcoma Group Study." United States. https://doi.org/10.1016/j.ijrobp.2007.11.023.
@misc{etde_21124368,
title = {Radiotherapy to Improve Local Control Regardless of Surgical Margin and Malignancy Grade in Extremity and Trunk Wall Soft Tissue Sarcoma: A Scandinavian Sarcoma Group Study}
author = {Jebsen, Nina L, Department of Oncology, Haukeland University Hospital, Bergen (Norway)], E-mail: njeb@helse-bergen.no, Trovik, Clement S, Department of Orthopedics, Haukeland University Hospital, Bergen (Norway)], Bauer, Henrik C.F., Rydholm, Anders, Monge, Odd R, Hall, Kirsten Sundby, Alvegard, Thor, Bruland, Oyvind S, and University of Oslo, Faculty Group, Norwegian Radium Hospital, Oslo (Norway)]}
abstractNote = {Purpose: Adjuvant radiotherapy has during the past decades become increasingly used in the treatment of localized soft tissue sarcoma. We evaluated the effect of radiotherapy (RT) on local recurrence rates (LRRs) in Scandinavia between 1986 and 2005. Methods and Materials: A total of 1,093 adult patients with extremity or trunk wall soft tissue sarcoma treated at four Scandinavian sarcoma centers were stratified according to the treatment period (1986-1991, 1992-1997, and 1998-2005). The use of adjuvant RT, quality of the surgical margin, interval between surgery and RT, and LRR were analyzed. The median follow-up was 5 years. Results: The use of RT (77% treated postoperatively) increased from 28% to 53%, and the 5-year LRR decreased from 27% to 15%. The rate of wide surgical margins did not increase. The risk factors for local recurrence were histologic high-grade malignancy (hazard ratio [HR], 5), an intralesional (HR, 6) or marginal (HR, 3) surgical margin, and no RT (HR, 3). The effect of RT on the LRR was also significant after a wide margin resection and in low-grade malignant tumors. The LRR was the same after preoperative and postoperative RT. The median interval from surgery to the start of RT was 7 weeks, and 98% started RT within 4 months. The LRR was the same in patients who started treatment before and after 7 weeks. Conclusion: The results of our study have shown that adjuvant RT effectively prevents local recurrence in soft tissue sarcoma, irrespective of the tumor depth, malignancy grade, and surgical margin status. The effect was most pronounced in deep-seated, high-grade tumors, even when removed with a wide surgical margin.}
doi = {10.1016/j.ijrobp.2007.11.023}
journal = []
issue = {4}
volume = {71}
place = {United States}
year = {2008}
month = {Jul}
}