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Andrews SF , Anderson PR , Eisenberg BL , Hanlon AL , Pollack A
Soft tissue sarcomas treated with postoperative external beam radiotherapy with and without low-dose-rate brachytherapy
International Journal of Radiation Oncology Biology Physics. 2004 Jun;59(2) :475-480
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Abstract
Purpose: Patients treated for soft tissue sarcoma with adjuvant low-dose-rate brachytherapy (BT) plus external beam radiotherapy (EBRT) were compared with those treated with adjuvant EBRT alone. The hypothesis was that higher doses from postoperative BT plus EBRT would improve local tumor control. Methods and Materials: The medical records of 130 sarcoma patients definitively treated between February 1983 and February 2001 were reviewed. Of these, 25 patients received BT followed by EBRT, and 61 were treated with EBRT alone. Overall survival, freedom from distant metastasis, and local control were calculated using Kaplan-Meier estimates. Univariate and multivariate analyses were performed. The mean postoperative radiation dose with EBRT alone was 59 Gy (range, 50-74) and 50 Gy (range, 40-70 Gy) when low-dose-rate BT was included. The mean implant dose was 16 Gy (range, 10-20 Gy). Results: The 5-year Kaplan-Meier estimate for overall survival for BT plus EBRT and EBRT alone was 82% and 72% (p = 0.93), respectively. The 5-year freedom from distant metastasis and freedom from local failure rate for BT plus EBRT vs. EBRT alone was 90% vs. 78% (p = 0.15) and 90% vs. 83% (p = 0.25), respectively. In the univariate subset analysis, Stage III patients had better local control at 5 years (100% vs. 62%, p = 0.03) and a trend was noted for better local control for high-grade tumors (100% vs. 74%,p = 0.09) if treated with BT plus EBRT. No statistically significant predictors were found on multivariate analysis for local control. The median follow-up was 62 months. Conclusion: Local control at 5 years was high in both groups at 83% and 90%. On univariate analysis, Stage III patients had improved 5-year local control and a trend was found toward better local control for high-grade tumors. On multivariate analysis, no predictors were found for better local control; however, the numbers of Stage III and high-grade patients were small, which may have masked a possible benefit of BT plus EBRT in this population. (C) 2004 Elsevier Inc.
Notes
English Article Anderson, PR; *Fox* *Chase* Canc Ctr, Dept Radiat Oncol, 7701 Burholme Ave, Philadelphia, PA 19111 USA. Research Addresses: *Fox* *Chase* Canc Ctr, Dept Radiat Oncol, Philadelphia, PA 19111 USA. *Fox* *Chase* Canc Ctr, Dept Surg Oncol, Philadelphia, PA 19111 USA. Cited References: *AM CANC SOC, 2002, CANC FACTS FIG 2002, P1 ALEKHTEYAR KM, 1996, INT J RADIAT ONCOL, V36, P321 ALEKTIAR KM, 2002, ANN SURG ONCOL, V9, P48 ALEKTIAR KM, 2002, J CLIN ONCOL, V20, P1643 BARKLEY HT, 1988, INT J RADIAT ONCOL, V14, P693 DAVIS AM, 2002, J CLIN ONCOL, V20, P4472 FRUSTACI S, 2001, J CLIN ONCOL, V19, P1238 GHERLINZONI F, 1990, CHIR ORG MOVIMENTO, V75, P150 KARASEK K, 1992, INT J RADIAT ONCOL, V24, P651 OSULLIVAN B, 2002, LANCET, V359, P2235 PISTERS PWT, 1996, J CLIN ONCOL, V14, P859 POLLACK A, 1998, INT J RADIAT ONCOL, V42, P563 RAVAUD A, 1990, ADJUVANT THERAPY CAN, V6, P556 ROSENBERG SA, 1982, ANN SURG, V196, P305 SCHRAY MF, 1990, CANCER, V66, P451 SPIRO IJ, 1996, P AN M AM SOC CLIN, V15, P524 SUIT HD, 1988, J CLIN ONCOL, V6, P854 Number of cited references: 17 Number of times cited: 0 Publisher: ELSEVIER SCIENCE INC; 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA. 0360-3016