Format

Send to

Choose Destination
Ann Surg Oncol. 2018 Mar;25(3):754-767. doi: 10.1245/s10434-017-6081-2. Epub 2017 Sep 11.

External Beam Radiation Therapy for Resectable Soft Tissue Sarcoma: A Systematic Review and Meta-Analysis.

Author information

1
Department of General, Visceral and Transplantation Surgery, Ludwig Maximilian University Hospital, Marchioninistr. 15, 81377, Munich, Germany.
2
Department of Medical Informatics, Biometry and Epidemiology-IBE, Research Unit for Biopsychosocial Health, Chair for Public Health and Health Care Research, Ludwig Maximilian University, Munich, Germany.
3
Furtwangen University, Furtwangen, Germany.
4
Department of Radiation Oncology, Ludwig Maximilian University Hospital, Ludwig-Maximilians-University, Munich, Germany.
5
Department of Molecular Radiation Oncology, German Cancer Research Center, Heidelberg, Germany.
6
Sarcoma Service, Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
7
Department of Oncology, Musculo-Skeletal Tumour Service, Haukeland University Hospital, Bergen, Norway.
8
Department of Clinical Science, University of Bergen, Bergen, Norway.
9
Department of Medical Oncology, Centre Léon Bérard, Lyon, France.
10
Department of Radiotherapy, Institut Bergonié, Bordeaux, France.
11
Department of Medical Oncology, Ludwig Maximilian University Hospital, Munich, Germany.
12
Department of General, Visceral and Transplantation Surgery, Ludwig Maximilian University Hospital, Marchioninistr. 15, 81377, Munich, Germany. Martin.Angele@med.uni-muenchen.de.

Abstract

PURPOSE:

The aim of this study was to evaluate the role of preoperative and postoperative external beam radiation therapy (EBRT) in the treatment of resectable soft tissue sarcomas (STSs) of different tumor locations.

METHODS:

A systematic literature search was performed to identify studies investigating the effects of EBRT (versus no EBRT) on local recurrence (LR) and overall survival (OS) or comparing different EBRT sequences. Random effects meta-analyses were calculated and presented as cumulative odds ratios (ORs).

RESULTS:

Sixteen studies (n = 3958 patients) comparing EBRT versus no EBRT, including one randomized controlled trial (RCT) in extremity sarcoma, were analyzed. EBRT appeared to reduce LR in both retroperitoneal tumors (OR 0.47, p < 0.0001) and other locations (OR 0.49, p = 0.001). OS was improved by EBRT in retroperitoneal STSs (OR 0.37, p < 0.0001) but not in other tumor locations. Eleven studies (n = 2140), including one RCT, compared preoperative and postoperative radiotherapy. LR was less frequent following preoperative EBRT in retroperitoneal STSs (OR 0.03, p = 0.02), as well as in other tumor locations (OR 0.67, p = 0.01), while wound complications in extremity sarcoma were more frequent following preoperative EBRT (OR 2.92, p < 0.0001). Several studies included in this meta-analysis bear a high risk of bias and no RCT has been published for retroperitoneal STS.

CONCLUSIONS:

This meta-analysis supports the use of EBRT for local tumor control in patients with resectable STSs. Based on a small number of non-randomized studies, a positive effect on OS may exist in the subgroup of retroperitoneal STSs.

PMID:
28895107
DOI:
10.1245/s10434-017-6081-2

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center