Adjuvant radiotherapy with brachytherapy boost in soft tissue sarcomas

Area of Science:

• Oncology
• Radiation Oncology
• Surgical Oncology

Background:

• Soft tissue sarcoma (STS) standard treatment involves wide surgical resection, often combined with radiotherapy.
• Intermediate-high risk STS requires effective therapeutic strategies to improve patient outcomes.
• Assessing novel or combined radiation techniques is crucial for enhancing treatment efficacy.

Purpose of the Study:

• To evaluate the efficacy of perioperative brachytherapy (BRT) combined with postoperative external beam radiation therapy (EBRT) for intermediate-high risk STS.
• To analyze overall survival (OS) and local control (LC) in patients treated with surgery, perioperative BRT, and adjuvant EBRT ± chemotherapy (CHT).
• To identify prognostic factors influencing LC, disease-free survival (DFS), and OS in STS patients.

Main Methods:

• Retrospective analysis of 107 patients with grade 2-3 primary or recurrent STS treated from 2000 to 2011.
• Treatment included surgery, perioperative BRT (20 Gy), and adjuvant EBRT (46 Gy PTV) using 3D-technique.
• Neoadjuvant/adjuvant chemotherapy (CHT) was administered for chemosensitive subtypes.

Main Results:

• Five-year local control (LC) was 80.9% and overall survival (OS) was 87.4%.
• Higher LC was observed in primary tumors versus recurrent tumors (p=0.015).
• Lower limb tumors showed improved LC (p=0.027) and DFS (p=0.034) compared to other sites.

Conclusions:

• The combination of BRT and EBRT yields satisfactory results for intermediate-high risk STS.
• Recurrent STS and tumors located outside the lower limb are associated with poorer local control.
• This combined radiation approach warrants consideration for selected STS patient populations.