Soft-tissue Sarcoma

Gilbert, Nathan F.; Cannon, Christopher P.; Lin, Patrick P.; Lewis, Valerae O.

doi:10.5435/00124635-200901000-00006

Cited by 100 publications

(85 citation statements)

References 34 publications

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“…Standard treatment of extremity soft tissue sarcoma (STS) consists of limb-sparing surgery and adjuvant radiation [2,3,5,14,15,17,21,30,42], although the mode and timing of radiotherapy continue to be debated [20-22, 27, 41]. Preoperative, intraoperative, and postoperative radiotherapy, administered by multiple delivery methods, all have described advantages and disadvantages [13,38] without one adjunct clearly demonstrating superiority.…”

Section: Introductionmentioning

confidence: 99%

Early Complications of High-dose-rate Brachytherapy in Soft Tissue Sarcoma: A Comparison With Traditional External-beam Radiotherapy

Emory

Montgomery

Potter

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Radiotherapy and surgery are routinely utilized to treat extremity soft tissue sarcoma. Multiple radiation modalities have been described, each with advantages and disadvantages, without one modality demonstrating clear superiority over the others.Questions/purposes We determined the overall initial complication rate in patients receiving surgery and radiotherapy, which specific complications were found when comparing different modalities, and whether combination therapy increased the overall rate of complications compared with surgery and single-modality radiotherapy. Patients and MethodsWe retrospectively reviewed the records of 190 patients who received external-beam radiotherapy (141 patients), high-dose-rate brachytherapy (37 patients), or both (12 patients). We evaluated 100 men and 90 women (mean age, 57 years; range, 18-94 years) for tumor size and subtype, comorbidities, stage, grade, margin of resection, type of adjuvant treatment, and complications. Minimum followup was 3 months (mean, 40 months; range, 3-155 months). Results The most frequent early complications in the high-dose-rate brachytherapy cohort were infection, cellulitis, and seroma and/or hematoma. In the external-beam radiotherapy cohort, chronic edema, fibrosis, and chronic radiation dermatitis were more frequently encountered. The total number of early complications and overall incidence of major complications requiring further surgery were similar among the three cohorts, but a larger number of patients in the high-dose-rate brachytherapy group required subsequent surgery for infection compared with the external-beam radiotherapy group. Conclusions High-dose-rate brachytherapy decreases radiation exposure and allows shorter duration of treatment compared with traditional external-beam radiotherapy but has a higher perioperative wound complication rate. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research. This work was performed at

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Section: Introductionmentioning

confidence: 99%

Early Complications of High-dose-rate Brachytherapy in Soft Tissue Sarcoma: A Comparison With Traditional External-beam Radiotherapy

Emory

Montgomery

Potter

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Lesions originating in the skull also behave differently and thus cannot be staged or classified using this system. The size of the primary tumor has been implicated as an important prognostic factor for numerous soft tissue sarcomas [6]. Larger lesions may be more likely to metastasize and may benefit from adjuvant chemotherapy [10].…”

Section: Limitationsmentioning

confidence: 99%

In Brief: Classifications in Brief

Jawad

Scully

2010

Clinical Orthopaedics &Amp; Related Research

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“…Because viable tumor cells can be found extending beyond the pseudocapsule, resection achieving a marginal surgical margin should be supplemented with radiation treatment to decrease local recurrence [2,6,8,15]. Since the original description of the STS pseudocapsule in a rat model, there have been several histological descriptions of the pseudocapsule in treated or untreated human STS and its response to adjuvant chemotherapy [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%