Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity

James C. Yang, Alfred E. Chang, Alan R. Baker, William F. Sindelar, David N. Danforth, Suzanne Topalian, Thomas DeLaney, Eli Glatstein, Seth M. Steinberg, Maria J. Merino, Steven A. Rosenberg

Research output: Contribution to journalArticle

Abstract

Purpose: This randomized, prospective study assesses the impact of postoperative external-beam radiation therapy on local recurrence (LR), overall survival (OS), and quality of life after limb-sparing resection of extremity sarcomas. Patients and Methods: Patients with extremity tumors and a limb-sparing surgical option were randomized to receive or not receive postoperative adjuvant external-beam radiotherapy. Patients with high-grade sarcomas received postoperative adjuvant chemotherapy whereas patients with low-grade sarcomas or locally aggressive nonmalignant tumors were randomized after surgery alone. Results: Ninety-one patients with high-grade lesions were randomized; 47 to receive radiotherapy (XRT) and 44 to not receive XRT. With a median follow-up of 9.6 years, a highly significant decrease (P2 = .0028) in the probability of LR was seen with radiation, but no difference in OS was shown. Of 50 patients with low-grade lesions (24 randomized to resection alone and 26 to resection and postoperative XRT), there was also a lower probability of LR (P2 = .016) in patients receiving XRT, again, without a difference in OS. A concurrent quality-of-life study showed that extremity radiotherapy resulted in significantly worse limb strength, edema, and range of motion, but these deficits were often transient and had few measurable effects on activities of daily life or global quality of life. Conclusion: This study indicates that although postoperative external-beam radiotherapy is highly effective in preventing LRs, selected patients with extremity soft tissue sarcoma who have a low risk of LR may not require adjuvant XRT after limb-sparing surgery (LSS).

Original languageEnglish (US)
Pages (from-to)197-203
Number of pages7
JournalJournal of Clinical Oncology
Volume16
Issue number1
StatePublished - Jan 1998
Externally publishedYes

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Sarcoma
Radiotherapy
Extremities
Prospective Studies
Recurrence
Quality of Life
Therapeutics
Survival
Adjuvant Chemotherapy
Articular Range of Motion
Edema
Neoplasms
Radiation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Yang, J. C., Chang, A. E., Baker, A. R., Sindelar, W. F., Danforth, D. N., Topalian, S., ... Rosenberg, S. A. (1998). Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. Journal of Clinical Oncology, 16(1), 197-203.

Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. / Yang, James C.; Chang, Alfred E.; Baker, Alan R.; Sindelar, William F.; Danforth, David N.; Topalian, Suzanne; DeLaney, Thomas; Glatstein, Eli; Steinberg, Seth M.; Merino, Maria J.; Rosenberg, Steven A.

In: Journal of Clinical Oncology, Vol. 16, No. 1, 01.1998, p. 197-203.

Research output: Contribution to journalArticle

Yang, JC, Chang, AE, Baker, AR, Sindelar, WF, Danforth, DN, Topalian, S, DeLaney, T, Glatstein, E, Steinberg, SM, Merino, MJ & Rosenberg, SA 1998, 'Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity', Journal of Clinical Oncology, vol. 16, no. 1, pp. 197-203.
Yang, James C. ; Chang, Alfred E. ; Baker, Alan R. ; Sindelar, William F. ; Danforth, David N. ; Topalian, Suzanne ; DeLaney, Thomas ; Glatstein, Eli ; Steinberg, Seth M. ; Merino, Maria J. ; Rosenberg, Steven A. / Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. In: Journal of Clinical Oncology. 1998 ; Vol. 16, No. 1. pp. 197-203.
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