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J Surg Res. 2013 Nov;185(1):245-9. doi: 10.1016/j.jss.2013.05.015. Epub 2013 May 29.

Intraoperative electron radiation therapy as an important treatment modality in retroperitoneal sarcoma.

Author information

1
Division of Surgical Oncology, University of North Carolina School of Medicine at Chapel Hill, Chapel Hill, North Carolina.

Abstract

BACKGROUND:

Local recurrence (LR) rates in patients with retroperitoneal sarcoma (RPS) are high, ranging from 40% to 80%, with no definitive studies describing the best way to administer radiation. Intraoperative electron beam radiation therapy (IOERT) provides a theoretical advantage for access to the tumor bed with reduced toxicity to surrounding structures. The goal of this study was to evaluate the role of IOERT in high-risk patients.

METHODS:

An institutional review board approved, single institution sarcoma database was queried to identify patients who received IOERT for treatment of RPS from 2/2001 to 1/2009. Data were analyzed using the Kaplan-Meier method, Cox regression, and Fisher Exact tests.

RESULTS:

Eighteen patients (median age 51 y, 25-76 y) underwent tumor resection with IOERT (median dose 1250 cGy) for primary (n = 13) and recurrent (n = 5) RPS. Seventeen patients received neoadjuvant radiotherapy. Eight high-grade and 10 low-grade tumors were identified. Median tumor size was 15 cm. Four patients died and two in the perioperative period. Median follow-up of survivors was 3.6 y. Five patients (31%) developed an LR in the irradiated field. Three patients with primary disease (25%) and two (50%) with recurrent disease developed an LR (P = 0.5). Four patients with high-grade tumors (57%) and one with a low-grade tumor (11%) developed an LR (P = 0.1). The 2- and 5-y OS rates were 100% and 72%. Two- and 5-y LR rates were 13% and 36%.

CONCLUSIONS:

Using a multidisciplinary approach, we have achieved low LR rates in our high-risk patient population indicating that IOERT may play an important role in managing these patients.

KEYWORDS:

Intraoperative radiation; Retroperitoneal sarcoma; Sarcoma

PMID:
23769633
PMCID:
PMC4166614
DOI:
10.1016/j.jss.2013.05.015
[Indexed for MEDLINE]
Free PMC Article
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