Re-irradiation of soft-tissue sarcoma

Br J Radiol. 1992 Feb;65(770):157-61. doi: 10.1259/0007-1285-65-770-157.

Abstract

Re-irradiation for local recurrence of malignancy after radical radiotherapy is of proven benefit at head and neck sites but has seldom been used elsewhere. This paper reports a series of 10 patients re-irradiated with external-beam techniques for local recurrence of soft-tissue sarcoma of the limb and limb girdle following initial limb conserving management with surgery and radiotherapy (dose range 33-60 Gy). Median survival was 14 months following re-treatment. Two cases received treatment with high-energy electrons and the rest with megavoltage photons. Five patients re-treated with radical intent (dose range 40-60 Gy) had a median survival of 36 months and median recurrence-free survival of 16 months. All five patients treated palliatively (dose range 12-50 Gy) have died, although two demonstrated local control until death. Acute reactions were not severe. Radionecrosis was seen in one patient who was re-irradiated twice (total dose 145 Gy) and subsequently required amputation. One other case required amputation for persistent local disease, but in the remaining eight, limb conservation was achieved. Re-irradiation of soft-tissue offers good local control and may avoid amputation.

MeSH terms

  • Adult
  • Aged
  • Arm
  • Female
  • Humans
  • Leg
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / radiotherapy*
  • Palliative Care / methods
  • Prognosis
  • Radiotherapy, High-Energy
  • Sarcoma / radiotherapy*
  • Soft Tissue Neoplasms / radiotherapy*
  • Thigh