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Title: Anticipated Intraoperative Electron Beam Boost, External Beam Radiation Therapy, and Limb-Sparing Surgical Resection for Patients with Pediatric Soft-Tissue Sarcomas of the Extremity: A Multicentric Pooled Analysis of Long-Term Outcomes

Purpose: To perform a joint analysis of data from 3 contributing centers within the intraoperative electron-beam radiation therapy (IOERT)-Spanish program, to determine the potential of IOERT as an anticipated boost before external beam radiation therapy in the multidisciplinary treatment of pediatric extremity soft-tissue sarcomas. Methods and Materials: From June 1993 to May 2013, 62 patients (aged <21 years) with a histologic diagnosis of primary extremity soft-tissue sarcoma with absence of distant metastases, undergoing limb-sparing grossly resected surgery, external beam radiation therapy (median dose 40 Gy) and IOERT (median dose 10 Gy) were considered eligible for this analysis. Results: After a median follow-up of 66 months (range, 4-235 months), 10-year local control, disease-free survival, and overall survival was 85%, 76%, and 81%, respectively. In multivariate analysis after adjustment for other covariates, tumor size >5 cm (P=.04) and R1 margin status (P=.04) remained significantly associated with local relapse. In regard to overall survival only margin status (P=.04) retained association on multivariate analysis. Ten patients (16%) reported severe chronic toxicity events (all grade 3). Conclusions: An anticipated IOERT boost allowed for external beam radiation therapy dose reduction, with high local control and acceptably low toxicity rates. The combined radiosurgical approach needs to be tested in a prospective trial tomore » confirm these results.« less
Authors:
 [1] ;  [2] ;  [3] ;  [1] ;  [2] ;  [4] ;  [5] ; ;  [6] ;  [7] ;  [8] ;  [5]
  1. Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain)
  2. (Spain)
  3. (Chile)
  4. Service of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid (Spain)
  5. Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona (Spain)
  6. Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid (Spain)
  7. Service of Pediatric Orthopedics and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid (Spain)
  8. Service of Orthopedics and Traumatology, Clínica Universidad de Navarra, Pamplona (Spain)
Publication Date:
OSTI Identifier:
22420423
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 90; Journal Issue: 1; Other Information: Copyright (c) 2014 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DATA ANALYSIS; DIAGNOSIS; ELECTRON BEAMS; EXTERNAL BEAM RADIATION THERAPY; LIMBS; METASTASES; MULTIVARIATE ANALYSIS; PATIENTS; PEDIATRICS; RADIATION DOSES; SARCOMAS; SURGERY; TOXICITY