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Radiother Oncol. 2016 Apr;119(1):30-4. doi: 10.1016/j.radonc.2016.02.029. Epub 2016 Mar 9.

Adjuvant radiation therapy in resected high-grade localized skeletal osteosarcomas treated with neoadjuvant chemotherapy: Long-term outcomes.

Author information

1
Department of Radiation Oncology, Clinica Instituto de Radiomedicina (IRAM), Santiago, Chile. Electronic address: cvsolep@iram.cl.
2
Department of Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; School of Medicine, Complutense University, Madrid, Spain.
3
Service of Radiation Oncology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
4
Service of Radiation Oncology, Clínica Universidad de Navarra, Pamplona, Spain.
5
Service of Orthopedic Surgery and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
6
Service of Orthopedic Surgery and Traumatology, Clínica Universidad de Navarra, Pamplona, Spain.
7
Department of Radiation Oncology, Clinica Instituto de Radiomedicina (IRAM), Santiago, Chile; Facultad de Medicina, Universidad Diego Portales, Santiago, Chile.
8
Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain.

Abstract

PURPOSE:

To assess long-term outcomes and toxicity of adjuvant radiotherapy in the post-surgical management of patients with resected high-grade skeletal osteosarcomas.

METHODS AND MATERIALS:

Seventy-two patients with primary resected osteosarcomas underwent adjuvant radiotherapy after neoadjuvant chemotherapy from December 1984 to December 2008. Local control (LC), overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-Meier methods. For survival outcomes potential associations were assessed in univariate and multivariate analyses using the Cox proportional hazards model.

RESULTS:

After a median follow-up of 174months (range, 33-363months), 10-year LC, DFS, and OS rates were 82%, 58%, and 73%, respectively. In the multivariate analysis only R1 margin status (p=0.02) remained significantly associated with LC. Patients with tumor necrosis <90% (p=0.04) and R1 resection margin (p=0.05) remained at a significantly higher risk of mortality on multivariate analysis. Six patients (8%) developed grade ⩾3 treatment-related chronic toxicity events. No grade 5 toxicities were reported.

CONCLUSIONS:

A multimodal radiotherapy-containing approach is a well-tolerated component of treatment for patients with osteosarcomas undergoing programed resection, allowing low toxicity rates while maintaining high local control rates.

KEYWORDS:

Local control; Osteosarcomas; Radiotherapy

PMID:
26970678
DOI:
10.1016/j.radonc.2016.02.029
[Indexed for MEDLINE]

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