Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity: 20-Year follow-up of a randomized prospective trial

Joal D. Beane, James C. Yang, Donald White, Seth M. Steinberg, Steven A. Rosenberg, Udo Rudloff

Research output: Contribution to journalArticle

Abstract

Background. This update of a randomized, prospective study presents the effect of external beam radiation therapy (EBRT) on long-term overall survival, local control, and limb function following limb-sparing surgery (LSS) for the treatment extremity soft tissue sarcoma (STS). Methods. Following LSS, patients with extremity STS were randomized to receive EBRT or surgery alone. All patients with high-grade STS received adjuvant chemotherapy. Long-term follow-up was obtained through telephone interviews using a questionnaire based on validated methods. Overall survival (OS) was determined by Kaplan-Meier method. Results. A total of 141 patients with extremity STS were randomized to receive adjuvant EBRT (n = 70) or LSS alone (n = 71). Median follow-up was 17.9 years. The 10- and 20-year survival was 77 % (95 % CI 66-85 %) and 64 % (95 % CI 52-75 %) for patients receiving LSS alone and 82 % (95 % CI 72-90 %) and 71 % (95 % CI 59-81 %) for patients receiving EBRT (p = 0.22). Of the 54 patients who completed telephone interviews, the incidence of local recurrence during the follow-up period was 4 % (1 of 24) in the LSS alone cohort compared with 0 % (0 of 30) in those who received EBRT (p = 0.44). Patients treated with EBRT tended to have more wound complications (17 vs. 12.5 %, p = 0.72), clinically significant edema (25 vs. 12 %, p = 0.31), and functional limb deficits (15 vs. 12 %, p = 0.84). Conclusions. Adjuvant EBRT following surgery for STS of the extremity provides excellent local control with acceptable treatment-related morbidity and no statistically significant improvement in overall survival.

Original languageEnglish (US)
Pages (from-to)2484-2489
Number of pages6
JournalAnnals of Surgical Oncology
Volume21
Issue number8
DOIs
StatePublished - 2014
Externally publishedYes

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Sarcoma
Radiotherapy
Extremities
Therapeutics
Survival
Interviews
Adjuvant Chemotherapy
Edema
Prospective Studies
Morbidity
Recurrence
Incidence
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Oncology
  • Medicine(all)

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Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity : 20-Year follow-up of a randomized prospective trial. / Beane, Joal D.; Yang, James C.; White, Donald; Steinberg, Seth M.; Rosenberg, Steven A.; Rudloff, Udo.

In: Annals of Surgical Oncology, Vol. 21, No. 8, 2014, p. 2484-2489.

Research output: Contribution to journalArticle

Beane, Joal D. ; Yang, James C. ; White, Donald ; Steinberg, Seth M. ; Rosenberg, Steven A. ; Rudloff, Udo. / Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity : 20-Year follow-up of a randomized prospective trial. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 8. pp. 2484-2489.
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title = "Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity: 20-Year follow-up of a randomized prospective trial",
abstract = "Background. This update of a randomized, prospective study presents the effect of external beam radiation therapy (EBRT) on long-term overall survival, local control, and limb function following limb-sparing surgery (LSS) for the treatment extremity soft tissue sarcoma (STS). Methods. Following LSS, patients with extremity STS were randomized to receive EBRT or surgery alone. All patients with high-grade STS received adjuvant chemotherapy. Long-term follow-up was obtained through telephone interviews using a questionnaire based on validated methods. Overall survival (OS) was determined by Kaplan-Meier method. Results. A total of 141 patients with extremity STS were randomized to receive adjuvant EBRT (n = 70) or LSS alone (n = 71). Median follow-up was 17.9 years. The 10- and 20-year survival was 77 {\%} (95 {\%} CI 66-85 {\%}) and 64 {\%} (95 {\%} CI 52-75 {\%}) for patients receiving LSS alone and 82 {\%} (95 {\%} CI 72-90 {\%}) and 71 {\%} (95 {\%} CI 59-81 {\%}) for patients receiving EBRT (p = 0.22). Of the 54 patients who completed telephone interviews, the incidence of local recurrence during the follow-up period was 4 {\%} (1 of 24) in the LSS alone cohort compared with 0 {\%} (0 of 30) in those who received EBRT (p = 0.44). Patients treated with EBRT tended to have more wound complications (17 vs. 12.5 {\%}, p = 0.72), clinically significant edema (25 vs. 12 {\%}, p = 0.31), and functional limb deficits (15 vs. 12 {\%}, p = 0.84). Conclusions. Adjuvant EBRT following surgery for STS of the extremity provides excellent local control with acceptable treatment-related morbidity and no statistically significant improvement in overall survival.",
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T1 - Efficacy of adjuvant radiation therapy in the treatment of soft tissue sarcoma of the extremity

T2 - 20-Year follow-up of a randomized prospective trial

AU - Beane, Joal D.

AU - Yang, James C.

AU - White, Donald

AU - Steinberg, Seth M.

AU - Rosenberg, Steven A.

AU - Rudloff, Udo

PY - 2014

Y1 - 2014

N2 - Background. This update of a randomized, prospective study presents the effect of external beam radiation therapy (EBRT) on long-term overall survival, local control, and limb function following limb-sparing surgery (LSS) for the treatment extremity soft tissue sarcoma (STS). Methods. Following LSS, patients with extremity STS were randomized to receive EBRT or surgery alone. All patients with high-grade STS received adjuvant chemotherapy. Long-term follow-up was obtained through telephone interviews using a questionnaire based on validated methods. Overall survival (OS) was determined by Kaplan-Meier method. Results. A total of 141 patients with extremity STS were randomized to receive adjuvant EBRT (n = 70) or LSS alone (n = 71). Median follow-up was 17.9 years. The 10- and 20-year survival was 77 % (95 % CI 66-85 %) and 64 % (95 % CI 52-75 %) for patients receiving LSS alone and 82 % (95 % CI 72-90 %) and 71 % (95 % CI 59-81 %) for patients receiving EBRT (p = 0.22). Of the 54 patients who completed telephone interviews, the incidence of local recurrence during the follow-up period was 4 % (1 of 24) in the LSS alone cohort compared with 0 % (0 of 30) in those who received EBRT (p = 0.44). Patients treated with EBRT tended to have more wound complications (17 vs. 12.5 %, p = 0.72), clinically significant edema (25 vs. 12 %, p = 0.31), and functional limb deficits (15 vs. 12 %, p = 0.84). Conclusions. Adjuvant EBRT following surgery for STS of the extremity provides excellent local control with acceptable treatment-related morbidity and no statistically significant improvement in overall survival.

AB - Background. This update of a randomized, prospective study presents the effect of external beam radiation therapy (EBRT) on long-term overall survival, local control, and limb function following limb-sparing surgery (LSS) for the treatment extremity soft tissue sarcoma (STS). Methods. Following LSS, patients with extremity STS were randomized to receive EBRT or surgery alone. All patients with high-grade STS received adjuvant chemotherapy. Long-term follow-up was obtained through telephone interviews using a questionnaire based on validated methods. Overall survival (OS) was determined by Kaplan-Meier method. Results. A total of 141 patients with extremity STS were randomized to receive adjuvant EBRT (n = 70) or LSS alone (n = 71). Median follow-up was 17.9 years. The 10- and 20-year survival was 77 % (95 % CI 66-85 %) and 64 % (95 % CI 52-75 %) for patients receiving LSS alone and 82 % (95 % CI 72-90 %) and 71 % (95 % CI 59-81 %) for patients receiving EBRT (p = 0.22). Of the 54 patients who completed telephone interviews, the incidence of local recurrence during the follow-up period was 4 % (1 of 24) in the LSS alone cohort compared with 0 % (0 of 30) in those who received EBRT (p = 0.44). Patients treated with EBRT tended to have more wound complications (17 vs. 12.5 %, p = 0.72), clinically significant edema (25 vs. 12 %, p = 0.31), and functional limb deficits (15 vs. 12 %, p = 0.84). Conclusions. Adjuvant EBRT following surgery for STS of the extremity provides excellent local control with acceptable treatment-related morbidity and no statistically significant improvement in overall survival.

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