Soft tissue sarcomas of the extremities: Their natural history, treatment, and radiation sensitivity

Abstract

The authors have attempted to explore the factors that influence the clinical course of a patient with a soft tissue tumor of the extremity (local recurrence, distant metastasis, and survival) by reviewing the literature as well as the cases at their institution. Do histology, site (proximal extremity versus distal extremity), age, or treatment significantly influence the natural history of the disease? As regards to treatment, the following questions must be answered. (1) Should the affected extremity be preserved? (2) Does the extent of local treatment really effect the likelihood of these tumors to disseminate? (3) Should ancillary local treatment such as radiation therapy be used and in what fashion? (4) If extremity‐saving techniques were found to be of equal value to amputation, what is the quality of survival in a patient with a compromised extremity (wide excision and irradiation), and would amputation with rehabilitation provide equal or better survival quality?

Advances in Segmental Endoprosthetic Reconstruction for Extremity Tumors: A Review of Contemporary Designs and Techniques

“…Nonetheless, tumor recurrence affects function (in the case of further soft-tissue and muscle excision) and may potentiate failure of endoprosthetic reconstructions. 4 More appropriate medical treatment of the tumor, radiotherapy, and surgical strategy are key in reducing the incidence of type V failures. 4,10,12,13,31,71,[79][80][81]86,110 …”

“…2,3 Earlier attempts at limb salvage had been reported; however, high rates of local recurrence limited its success. 4 The development of adjuvant therapies during the latter half of the 20th century has allowed investigators to revisit limb salvage as a means of treating primary sarcomas and metastatic tumors in the extremities. 4,5 With the advent of neoadjuvant chemotherapy and radiation therapy in combination with contemporary surgical techniques, several investigators in the 1970s successfully performed segmental endoprosthetic reconstructions for patients with tumors previously considered unresectable.…”

The Radiation Response of Sarcomas by Histologic Subtypes: A Review With Special Emphasis Given to Results Achieved With Razoxane

“…The few reports on photon irradiation deal mainly with soft tissue sarcomas (STS) as a group [ 1 , 2 ]. Radiation therapy alone leads to transient objective response rates up to 50% and local tumor control in about 30% of unresectable lesions with radiation doses in the order of 60 to 70 Gy [ 1 – 3 ]. Improvements in local control and response rates between 50% and 75% have been achieved by high-LET irradiation [ 4 – 7 ], the use of radiosensitizers such as intravenous bromodeoxyuridine, iododeoxyuridine [ 8 ], razoxane [ 9 ], or hyperthermia.…”

Ilizarov method as limb salvage in treatment of massive femoral defect after unsuccessful tumor arthroplasty

“…Ewing sarcoma is a highly malignant tumor. In most cases its origin is in bone tissue (approximately 10% origina-tes from tissues that are surrounding bone) 1 . Population younger than 30 years is usually affected 2 .…”