Minsi Zhang1, Aimee Crago2, Sam S Yoon2, Samuel Singer2, Kaled Alektiar3. 1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA. 2. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA. 3. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA. alektiak@mskcc.org.
Abstract
PURPOSE: Despite anatomical differences, truncal soft tissue sarcomas (STS) often are grouped with extremity sarcomas. We evaluated the clinical outcome of patients with truncal STS who underwent gross total resection (GTR) and radiation therapy (RT), with special emphasis on those treated with intensity modulated radiation therapy (IMRT). METHODS: From January 1, 2001 to December 31, 2018, 64 patients received GTR and RT, where 48 patients were male, 35 patients were aged ≤ 60 years, and 48 patients had tumors ≤ 10 cm. Sixty-two tumors were high grade, 36 were in the chest wall, 7 in the abdominal wall, and 21 were paraspinal. During surgery, 7 received mesh reconstruction, and 6 received flap closure. R0 resection was achieved in 53 patients. Thirteen patients received chemotherapy. RESULTS: With a median follow-up of 57 months, the 5-year actuarial local control (LC) was 71%. In the IMRT subset (50/64, 78%), the 5-year LC for the chest/abdominal wall was 84%, and 69% for the paraspinal subsite. Grade 2+ radiation dermatitis was seen in 21 of 64 (33%) patients, 5 of 64 (8%) developed noninfectious wound complications, 5 of 64 (8%) developed infectious wound complications, and 1 of 64 (2%) developed grade 2 chest wall pain. No additional grade 2+ late toxicity was observed. CONCLUSIONS: Based on this study, achieving LC in truncal STS treated with GTR and RT remains challenging even with IMRT (5-year LC: 78%). While the use of IMRT was more promising for tumors of the chest/abdominal wall with 5-year LC of 84%, it was 69% for those located in the paraspinal subsite, indicating a need for further improvement.
PURPOSE: Despite anatomical differences, truncal soft tissue sarcomas (STS) often are grouped with extremity sarcomas. We evaluated the clinical outcome of patients with truncal STS who underwent gross total resection (GTR) and radiation therapy (RT), with special emphasis on those treated with intensity modulated radiation therapy (IMRT). METHODS: From January 1, 2001 to December 31, 2018, 64 patients received GTR and RT, where 48 patients were male, 35 patients were aged ≤ 60 years, and 48 patients had tumors ≤ 10 cm. Sixty-two tumors were high grade, 36 were in the chest wall, 7 in the abdominal wall, and 21 were paraspinal. During surgery, 7 received mesh reconstruction, and 6 received flap closure. R0 resection was achieved in 53 patients. Thirteen patients received chemotherapy. RESULTS: With a median follow-up of 57 months, the 5-year actuarial local control (LC) was 71%. In the IMRT subset (50/64, 78%), the 5-year LC for the chest/abdominal wall was 84%, and 69% for the paraspinal subsite. Grade 2+ radiation dermatitis was seen in 21 of 64 (33%) patients, 5 of 64 (8%) developed noninfectious wound complications, 5 of 64 (8%) developed infectious wound complications, and 1 of 64 (2%) developed grade 2 chest wall pain. No additional grade 2+ late toxicity was observed. CONCLUSIONS: Based on this study, achieving LC in truncal STS treated with GTR and RT remains challenging even with IMRT (5-year LC: 78%). While the use of IMRT was more promising for tumors of the chest/abdominal wall with 5-year LC of 84%, it was 69% for those located in the paraspinal subsite, indicating a need for further improvement.
Authors: Michael R Folkert; Samuel Singer; Murray F Brennan; Deborah Kuk; Li-Xuan Qin; Wendy K Kobayashi; Aimee M Crago; Kaled M Alektiar Journal: J Clin Oncol Date: 2014-09-02 Impact factor: 44.544
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Authors: Clement Trovik; Henrik C F Bauer; Emelie Styring; Kirsten Sundby Hall; Fredrik Vult Von Steyern; Sigvard Eriksson; Ingela Johansson; Mika Sampo; Minna Laitinen; Anders Kalén; Halldór Jónsson; Nina Jebsen; Mikael Eriksson; Erkki Tukiainen; Najme Wall; Olga Zaikova; Helgi Sigurðsson; Tuula Lehtinen; Bodil Bjerkehagen; Mikael Skorpil; Geir Egil Eide; Elisabeth Johansson; Thor A Alvegard Journal: Acta Orthop Date: 2017-03-07 Impact factor: 3.717