Abstract
PurposeTo evaluate the efficacy and tolerance of adjuvant concurrent chemoradiation (CCRT) as treatment of grade 2 and 3 (G2-3) localized extremity soft tissue sarcomas (STS) by comparing CCRT with standard adjuvant radiation therapy (RT). Patients and methodsThis monocentric retrospective study included non-pediatric patients (>16years) treated by adjuvant RT with or without chemotherapy (CT) after conservative resection of non-recurrent G2-3 extremity STS. ResultsA total of 80 patients were treated between 1990 and 2012: 51 by RT and 29 by CCRT. Of the 29 CCRT patients, 25 received doxorubicin monotherapy (75mg/m2/3weeks). The CCRT group contained a greater proportion of grade 3 extremity STS (p<0.001). Median follow up was 68months (9–284). Multivariate analysis revealed greater local control in the CCRT group (1 local recurrence vs 8 in the RT group; HR=0.082, 95% CI 0.011–0.321) and incomplete resection as the major risk factor of local recurrence (HR=25.2, 95% CI 4.767–133.226). The two groups exhibited no differences in distant failure-free survival (HR=1.469, 95% CI 0.668–3.228), disease-free survival (HR=1.096, 95% CI 0.519–2.315) or overall survival (HR=1.378, 95% CI 0.498–3.814). Grade 3 was an adverse prognostic factor for overall survival (HR=3.11, 95% CI 1.04–9.32). Our analyses also revealed that CCRT tended to increase the risk of both grade ≥3 acute dermatitis (14 events vs 6 in the RT group; OR=6.99, 95% CI 2.28–21.47) and grade ≥2 late toxicity (6 events vs 3 in the RT group; p=0.0572). ConclusionCCRT could improve local control as part of a limb-preservation strategy. However, with a limited number of patients, CCRT showed no improvement in either distant control or survival and increased toxicity.
Published Version
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