Clinical Outcomes of Intraoperative Radiation Therapy for Extremity Sarcomas
Quy N. H. Tran,
Anne C. Kim,
Alexander R. Gottschalk,
William M. Wara,
Theodore L. Phillips,
Richard J. O'Donnell,
Vivian Weinberg,
Daphne A. Haas-Kogan
Affiliations
Quy N. H. Tran
Department of Radiation Oncology, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94143-1708, USA
Anne C. Kim
Department of Radiation Oncology, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94143-1708, USA
Alexander R. Gottschalk
Department of Radiation Oncology, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94143-1708, USA
William M. Wara
Department of Radiation Oncology, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94143-1708, USA
Theodore L. Phillips
Department of Radiation Oncology, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94143-1708, USA
Richard J. O'Donnell
Department of Orthopaedic Surgery, Comprehensive Cancer Center, University of California at San Francisco, 1600 Divisadero Street, 4th Floor, San Francisco, CA 94143-1708, USA
Vivian Weinberg
Biostatistics Core, Comprehensive Cancer Center, University of California at San Francisco, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94143-1708, USA
Daphne A. Haas-Kogan
Department of Radiation Oncology, Comprehensive Cancer Center, 1600 Divisadero Street, Suite H1031, San Francisco, CA 94143-1708, USA
Purpose. Radiation of extremity lesions, a key component of limb-sparing therapy, presents particular challenges, with significant risks of toxicities. We sought to explore the efficacy of intraoperative radiation therapy (IORT) in the treatment of soft tissue sarcomas of the extremities. Patients. Between 1995 and 2001, 17 patients received IORT for soft tissue sarcomas of the extremities. Indications for IORT included recurrent tumors in a previously radiated field or tumors adjacent to critical structures. Results. Gross total resections were achieved in all 17 patients. Two patients experienced locoregional relapses, six patients recurred at metastatic sites, and one patient died without recurrence. Thirty-six month estimates for locoregional control, disease free survival, and overall survival were 86%, 50%, and 78%, respectively. IORT was extremely well tolerated, with no toxicities referable to IORT. Conclusions. For patients with soft tissue sarcomas of the extremities, IORT used as a boost to EBRT provides excellent local control, with limited acute toxicities.
