Postoperative radiotherapy in the management of adult soft tissue sarcoma of the extremities: Results with two different total dose, fractionation, and overall treatment time schedules

Purpose: This retrospective study was performed to evaluate two postoperati ve radiotherapy schedules in terms of dose, fractionation, and overall trea tment time in soft tissue sarcoma (STS) of the extremities. Methods and Materials: Between January 1984 and December 1993, 62 patients with newly diagnosed localized STS of the extremities were treated with max imal conservative surgery and postoperative radiotherapy (RT). Forty-five p atients received 50 Gy with conventional fractionation plus a boost dose (5 to 20 Gy). Seventeen patients had hyperfractionated accelerated radiothera py (HFART) up to a dose of 45 Gy in 3 weeks. Results: With a median follow-up of 72 months, the 5-year local failure rat e was 25%, the 5-year disease-free and overall survival rates were respecti vely 42% and 62%. The 3-year local relapse, disease-free, and overall survi val rates were respectively 16%, 44%, and 70% in the conventional radiother apy group, and 36%, 47%, and 82% in the HFART group (NS). No factor signifi cantly influenced local control with a trend, however, in favor of conventi onal RT (p = 0.10). Conclusion: HFART at the dose of 45 Gy does not seem to be superior to the standard RT schedule, neither in terms of local control, survival, nor in t erms of long-term side effects. However this dose could be considered too l ow as well as the power of comparison between the two groups to draw defini tive conclusions. (C) 1999 Elsevier Science Inc.