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An effective preoperative three-dimensional radiotherapy target volume for extremity soft tissue sarcoma and the effect of margin width on local control.

Publication ,  Journal Article
Kim, B; Chen, Y-LE; Kirsch, DG; Goldberg, SI; Kobayashi, W; Kung, JH; Wolfgang, JA; Doppke, K; Rosenberg, AE; Nielsen, GP; Raskin, KA ...
Published in: Int J Radiat Oncol Biol Phys
July 1, 2010

PURPOSE: There is little information on the appropriate three-dimensional (3D) preoperative radiotherapy (XRT) volume for extremity soft-tissue sarcomas (STS). We retrospectively analyzed the pattern of local failure (LF) to help elucidate optimal field design. METHODS AND MATERIALS: We analyzed the 56 patients who underwent computed tomography-planned XRT for Stage I to III extremity STS between June 2000 and December 2006. Clinical target volume (CTV) included the T1 post-gadolinium-defined gross tumor volume with 1- to 1.5-cm radial and 3.5-cm longitudinal margins. Planning target volume expansion was 5 to 7 mm, and >or=95% of dose was delivered to the planning target volume. Preoperative XRT was 44 to 50.4 Gy (median, 50). Postoperative boost of 10 to 20 Gy was given to 12 patients (6 with positive and 6 with close margins). RESULTS: Follow-up ranged from 15 to 76 months (median, 41 months). The 5-year local control, freedom from distant metastasis, disease-free survival, and overall survival were 88.5%, 80.0%, 77.5% and 82.8%, respectively. Three patients (all with positive margin) experienced local failure (LF) as first relapse (2 isolated, 1 with distant failure), and 2 additional patients (all with margin<1 mm) had late LF after distant metastasis. The LFs were within the CTV in 3 patients and within and also extending beyond the CTV in 2 patients. CONCLUSIONS: These target volume definitions appear to be appropriate for most patients. No local recurrences were observed with surgical margins >or=1 mm, and it appears that these may be adequate for patients with extremity STS treated with preoperative radiotherapy.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

July 1, 2010

Volume

77

Issue

3

Start / End Page

843 / 850

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Failure
  • Soft Tissue Neoplasms
  • Sarcoma
  • Radiotherapy Dosage
  • Preoperative Care
  • Postoperative Complications
  • Oncology & Carcinogenesis
  • Middle Aged
 

Citation

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Kim, B., Chen, Y.-L., Kirsch, D. G., Goldberg, S. I., Kobayashi, W., Kung, J. H., … DeLaney, T. F. (2010). An effective preoperative three-dimensional radiotherapy target volume for extremity soft tissue sarcoma and the effect of margin width on local control. Int J Radiat Oncol Biol Phys, 77(3), 843–850. https://doi.org/10.1016/j.ijrobp.2009.06.086
Kim, BoKyong, Yen-Lin E. Chen, David G. Kirsch, Saveli I. Goldberg, Wendy Kobayashi, Jong Hyun Kung, John A. Wolfgang, et al. “An effective preoperative three-dimensional radiotherapy target volume for extremity soft tissue sarcoma and the effect of margin width on local control.Int J Radiat Oncol Biol Phys 77, no. 3 (July 1, 2010): 843–50. https://doi.org/10.1016/j.ijrobp.2009.06.086.
Kim B, Chen Y-LE, Kirsch DG, Goldberg SI, Kobayashi W, Kung JH, et al. An effective preoperative three-dimensional radiotherapy target volume for extremity soft tissue sarcoma and the effect of margin width on local control. Int J Radiat Oncol Biol Phys. 2010 Jul 1;77(3):843–50.
Kim, BoKyong, et al. “An effective preoperative three-dimensional radiotherapy target volume for extremity soft tissue sarcoma and the effect of margin width on local control.Int J Radiat Oncol Biol Phys, vol. 77, no. 3, July 2010, pp. 843–50. Pubmed, doi:10.1016/j.ijrobp.2009.06.086.
Kim B, Chen Y-LE, Kirsch DG, Goldberg SI, Kobayashi W, Kung JH, Wolfgang JA, Doppke K, Rosenberg AE, Nielsen GP, Raskin KA, Springfield DS, Schwab JH, Gebhardt MC, Yoon SS, Hornicek FJ, DeLaney TF. An effective preoperative three-dimensional radiotherapy target volume for extremity soft tissue sarcoma and the effect of margin width on local control. Int J Radiat Oncol Biol Phys. 2010 Jul 1;77(3):843–850.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

July 1, 2010

Volume

77

Issue

3

Start / End Page

843 / 850

Location

United States

Related Subject Headings

  • Young Adult
  • Tumor Burden
  • Treatment Failure
  • Soft Tissue Neoplasms
  • Sarcoma
  • Radiotherapy Dosage
  • Preoperative Care
  • Postoperative Complications
  • Oncology & Carcinogenesis
  • Middle Aged