Surgical resection and radiotherapy for primary retroperitoneal soft tissue sarcoma

被引:91
作者
Gilbeau, L
Kantor, G
Stoeckle, E
Lagarde, P
Thomas, L
Kind, M
Richaud, P
Coindre, JM
Bonichon, F
Bui, BN
机构
[1] Inst Bergonie, Dept Radiat Oncol, Reg Canc Ctr, F-33076 Bordeaux, France
[2] Inst Bergonie, Dept Surg, Reg Canc Ctr, F-33076 Bordeaux, France
[3] Inst Bergonie, Dept Pathol, Reg Canc Ctr, F-33076 Bordeaux, France
[4] Inst Bergonie, Biostat Unit, Reg Canc Ctr, F-33076 Bordeaux, France
[5] Inst Bergonie, Dept Med Oncol, Reg Canc Ctr, F-33076 Bordeaux, France
关键词
surgery; radiotherapy; soft tissue sarcoma;
D O I
10.1016/S0167-8140(02)00283-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Methods and materials: Forty-five patients were consecutively treated for primary retroperitoneal soft tissue sarcoma with surgery in combination with radiation therapy in the same institution. The median follow-up time was 53 months (7-108). Results: Seventeen (38%) patients had clear microscopic margins (R0 resection), 26 patients (58%) had gross complete surgical excision (R1 resection) and two patients (4%) had a macroscopic residual disease (R2 resection). External radiotherapy doses ranged from 40.8 to 59.4 Gy (mean and median: 49 Gy). Seventeen patients underwent intraoperative radiation therapy (IORT). Moreover, 11 patients received chemotherapy. The overall 1-, 2-, and 5-year survival for all 45 patients were 93, 85 and 60%, respectively. The 1-, 2-, and 5-year locoregional relapse-free rate for the whole group was 91, 70 and 40%, respectively. In univariate analysis, quality of surgery was the only variable to show a significant effect for overall survival (P = 0.0386) and for local control (P = 0.0059). Tumor size and tumor grade had no statistically significant effect. For the patients receiving IORT + external beam radiation therapy, no difference was observed for survival or locoregional control. The most frequent acute side effects treatment complications were radiation-induced nausea or vomiting (42%) and moderate enteritis (30%). Significant late morbidity was observed for two patients. Conclusions: This study confirms the feasibility of external postoperative radiotherapy with an acceptable level of toxicity. However, the high rate of local relapses (especially in field of radiation) does not demonstrate the usefulness of radiotherapy at the level of dose used and further preferably randomized studies should be planned. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
引用
收藏
页码:137 / 143
页数:7
相关论文
共 24 条
[1]  
Agapito J, 1999, Med Dosim, V24, P189, DOI 10.1016/S0958-3947(99)00017-5
[2]   High-dose-rate intraoperative radiation therapy (HDR-IORT) for retroperitoneal sarcomas [J].
Alektiar, KM ;
Hu, K ;
Anderson, L ;
Brennan, MF ;
Harrison, LB .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2000, 47 (01) :157-163
[3]  
Bonvalot S, 1999, J CHIR-PARIS, V136, P61
[4]  
Bussieres E, 1996, J SURG ONCOL, V62, P49, DOI 10.1002/(SICI)1096-9098(199605)62:1<49::AID-JSO11>3.0.CO
[5]  
2-O
[6]   OUTCOME AND PROGNOSIS IN RETROPERITONEAL SOFT-TISSUE SARCOMA [J].
CATTON, CN ;
OSULLIVAN, B ;
KOTWALL, C ;
CUMMINGS, B ;
HAO, Y ;
FORNASIER, V .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1994, 29 (05) :1005-1010
[7]  
Clark J A, 1996, Oncology (Williston Park), V10, P1867
[8]   TOXICITY CRITERIA OF THE RADIATION-THERAPY ONCOLOGY GROUP (RTOG) AND THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER (EORTC) [J].
COX, JD ;
STETZ, J ;
PAJAK, TF .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (05) :1341-1346
[9]   MANAGEMENT OF RETROPERITONEAL SARCOMAS - DOES DOSE-ESCALATION IMPACT ON LOCOREGIONAL CONTROL [J].
FEIN, DA ;
CORN, BW ;
LANCIANO, RM ;
HERBERT, SH ;
HOFFMAN, JP ;
COIA, LR .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (01) :129-134
[10]  
GLENN J, 1985, SURGERY, V97, P316