Neutron and neutron boost irradiation of soft tissue sarcomas

The results of neutron and neutron boost irradiation of 199 patients with soft tissue sarcomas treated between 1978 and 1983 are presented. The median follow-up period is 42 months. The recurrence free survival rates by last review are 93% for patients with T1 tumours (n = 14), 87% for T2 tumours (n = 84) and 73% for T3 tumours (n = 101). The actuarial survival rates at six years are 77% for T1, 63% for T2 and 34% for T3 tumours (p = 0.018). The actuarial survival rate for the group of patients irradiated after surgery without clinical evidence of residual tumour is 63.8% compared with 30.9% for the group of patients with measurable tumour volume at the beginning of radiotherapy (p = 0.002). The survival rates according to grading are 52% for patients with G1 tumours (n = 44), 54% for G2 tumours (n = 130) and 36% for G3 tumours (n = 25). The morbidity rate of 22% after full neutron irradiation was reduced to 15% by the introduction of a neutron boost. At the present time, the results of this modified treatment are not inferior to a full neutron course. The effectiveness of neutron or neutron boost irradiation in the postoperative treatment of soft tissue sarcomas will be evaluated in a forthcoming EORTC trial.