Combined treatment of patients with limbs and trunk soft tissue sarcoma

Korovin S., Ivankova V.S., Ostafiichuk V., Palivets A., Kukushkina M.M., Paliy M.I.

Summary. Soft tissue sarcomas (STS) are relatively few common pathology, ranged from 1.0 to 2.5% of all malignancies in adults. This type of tumors has poor prognosis and features course. We analyzed the results of treatment of patients with STS II–III stage, depending on the regimen of combined treatment with a combination of radiation therapy (RT) and radical surgery. All patients were divided into 4 groups. The first group consisted of 53 patients, who received treatment in the amount of neoadjuvant (NA) RT (total focal dose (TFD) 40–45 Gy) followed by surgery. Group 2 consisted of 75 patients: course of RT (TFD 30–35 Gy), surgery followed by adjuvant RT in the postoperative scar in TFD 15–20 Gy. Group 3 consisted of 95 patients in whom treatment began with surgical after was adjuvant RT to the area of postsurgical scar (TFD 50–55 Gy). Group 4 consisted of 60 patients: a course of NA RT 20 Gy TFD at a single focal dose 5.0 Gy and radical removal of the tumor. Overall survival at 3 years in group 1 was 64.3%, in group 2 — 69.2%, group 3 — 52.7%, group 4 — 66.8%. Local control was equal to 3 years 48.8; 46.3; 37.9 and 43.4%, respectively, and nonmetastatic 3-years survival rate — 51.0; 61.6; 49.5 and 63.6%, respectively. These data show the advantage of using regimen with NA and adjuvant RT over other treatment regimens. We can conclude about the prospects of a combination of NA and adjuvant RT in treatment of patients with STS.
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