Role of post‐operative radiation boost for soft tissue sarcomas with positive margins following pre‐operative radiation and surgery. Issue 7 (11th August 2014)

• Record Type: Journal Article
• Authors: Pan, Elizabeth; Goldberg, Saveli I.; Chen, Yen‐Lin; Giraud, Christine; Hornick, Jason L.; Nielsen, Gunnlaugur P.; Hornicek, Francis J.; Raut, Chandrajit P.; DeLaney, Thomas F.; Baldini, Elizabeth H.
• Is Part Of: Journal of surgical oncology. Volume 110:Issue 7(2014:Dec. 01)
• Page Start: 817
• Page End: 822
• Publication Date: 2014-08-11
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23741
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23741-sec-0001" sec-type="section"> <title>Background and Objectives</title> <p>The role of a radiation therapy (RT) boost for positive margins following pre‐operative RT and surgery in extremity soft tissue sarcomas (STS) is unclear. We assessed the contribution of a boost to local control (LC), disease‐free survival (DFS), and overall survival (OS).</p> </sec> <sec id="jso23741-sec-0002" sec-type="section"> <title>Methods</title> <p>We identified 67 patients treated from 1987 to 2011 with pre‐operative RT and surgery with positive margin(s). Select patients received a boost delivered as peri‐operative Iridium‐192 brachytherapy (BRT), intra‐operative electrons (IORT), or post‐operative external beam RT (EBRT).</p> </sec> <sec id="jso23741-sec-0003" sec-type="section"> <title>Results</title> <p>Ten patients received no RT boost, 10 received a BRT or IORT boost, and 47 received an EBRT boost. Five‐year LC rates for no boost, BRT/IORT boost, and EBRT boost were 100%, 78%, and 71% (<italic>P</italic> = 0.5). On multivariate analysis, there were no significant predictors for LC. Variables associated with improved DFS rates were single positive margin (<italic>P</italic> = 0.007) and low tumor grade (<italic>P</italic> = 0.03). Tumor size <5 cm (<italic>P</italic> = 0.003), low grade (<italic>P</italic> = 0.001), and boost (<italic>P</italic> = 0.02) were associated with longer survival.</p> </sec> <sec id="jso23741-sec-0004" sec-type="section"> <title>Conclusions</title> <p>We did not identify a LC advantage for an RT boost. Given the unidentified selection factors for delivery of boost and its potential toxicities, its role in this setting remains unproven. <italic>J. Surg. Oncol. 2014 110:817–822</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>