[Radiotherapy as conservative therapy for sarcomas within the irradiated field]

Abstract

Purpose: To describe long-term outcome after combined-modality treatment including radiation therapy in patients with localized sarcoma within irradiated field.

Patients and methods: Individual clinical data from all consecutive patients diagnosed and treated for a localized sarcoma within irradiated field between January 2000 and October 2011 at the Institut Claudius-Regaud, Toulouse, France, were retrospectively reviewed.

Results: Twenty-seven patients were eligible for this study. Ten patients were re-irradiated with a rate of unresectable, gross or microscopically positive margins disease significantly higher than the rest of the cohort (90% vs. 12%; P<0.001). After a median follow-up of 3.8 years, there is a non-significant trend toward longer 4-year relapse free survival in the subgroup of patients who received adjuvant or definitive radiation therapy compared to the rest of the cohort (53% vs. 27%; P=0.09) with an acceptable toxicity profile allowing conservative management.

Conclusion: The complete surgical resection sarcoma within irradiated field is often difficult to achieve enhancing the risk of relapse. Radiation therapy should be discussed when faced with an unresectable tumour or after suboptimal surgery as part of intensified local management with a curative intent.

Keywords: Conservative therapy; Radiation therapy; Radio-induced sarcoma; Radiothérapie; Reirradiation; Ré-irradiation; Sarcome radio-induit; Sequalae; Séquelles; Traitement conservateur.