Salvage surgery and radiotherapy including intraoperative electron radiotherapy in isolated locally recurrent tumors: Predictors of outcome. Issue 2 (August 2015)

• Record Type: Journal Article
• Authors: Cambeiro, Mauricio; Calvo, Felipe A.; Aristu, José Javier; Jimenez, Marta Moreno; San-Julian, Mikel; Alcalde, Juan; Hernandez-Lizoain, Jose Luis; Jurado, Matías; Martínez-Monge, Rafael
• Is Part Of: Radiotherapy and oncology. Volume 116:Issue 2(2015:Aug.)
• Page Start: 316
• Page End: 322
• Publication Date: 2015-08
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.07.009
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Purpose</title> <p id="sp0005">To evaluate the influence of equivalent dose (EQD2) in clinical outcomes of patients with isolated locally recurrent tumors (ILRT), treated with salvage surgery and intra-operative electron beam radiation therapy (IOERT).</p> </sec> <sec> <title id="st015">Methods and materials</title> <p id="sp0010">We retrospectively reviewed 128 patients with non-metastatic ILRT of different tissues (soft tissue sarcomas, head and neck, uterine, and colorectal). Patients had received salvage surgery (R0/R1/R2) and IOERT. Previously not irradiated patients had received additional external beam radiation therapy (EBRT).</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">IOERT was delivered at a median dose of 15 Gy (range, 5–25 Gy). Seventy-five patients (60.9%) received additional EBRT of 46 Gy.</p> <p id="sp0020">Median EQD2 of salvage program was 62 Gy and median EQD2 of exclusive IORT was 31.2 Gy. Median follow-up was 19.2 months (range: 1.3–220). Thirty-one patients (24.2%) developed severe (grade 3–5) complications. New locoregional recurrence was documented in 86 (67.2%) of the 123 cases. Five-year rates were 31% for locoregional control, 57% for distant metastasis-free and 31% for overall survival. On multivariate analysis, R0–1 vs. R2 resection (HR 2.2, 95 CI: 1.2–4.1) was statistically significant for locoregional recurrence and EQD2 ⩾62 Gy for survival (HR 2.2, 95 CI: 1.1–4.1).</p> </sec> <sec> <title id="st025">Conclusions</title> <p id="sp0025">Surgical radicality (gross macroscopic resection) and radiation dose (EQD2 ⩾62 Gy in radiation salvage program) are the dominant prognostic factors beside ILRT histology. Modest rates of long-term disease control are expected when both factors are fulfilled.</p> </sec> </abstract>