Long-term experience with intraoperative electron radiation therapy boost in extremity sarcoma

Area of Science:

• Orthopedic Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Extremity soft tissue sarcoma (eSTS) presents unique treatment challenges.
• Multimodal treatment strategies are often necessary for optimal outcomes.

Purpose of the Study:

• To describe outcomes of a combined treatment approach for eSTS.
• To evaluate the efficacy and toxicity of preoperative external beam radiation therapy (EBRT), limb-sparing surgery (LSS), and intraoperative electron radiation therapy (IOERT).

Main Methods:

• A retrospective review of 118 patients with eSTS treated between 2002 and 2021.
• Patients received preoperative EBRT followed by LSS and IOERT.

Main Results:

• High 5-year local control (94%), failure-free survival (75%), and overall survival (64%).
• Negative surgical margins achieved in 89% of patients.
• Low rates of severe late toxicity, including fracture (6%) and osteoradionecrosis (1%).

Conclusions:

• Preoperative EBRT, LSS, and IOERT is an effective treatment for eSTS.
• This approach yields high local control with acceptable toxicity.
• This is one of the largest series demonstrating these outcomes.