Adjuvant radiotherapy in the management of soft tissue sarcoma involving the distal extremities

Schoenfeld, Gordon O.; Morris, C. D.; Scarborough, Mark T.; Zlotecki, Robert A.

doi:10.1016/s0360-3016(04)01300-8

Cited by 3 publications

(3 citation statements)

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“…16 Of the 23 patients in that series evaluated over a period of 26 years, 12 had lesions of the hand and wrist, whereas the other 11 had lesions of the foot. The late effects of radiation in their patients included edema (14%), fibrosis (24%), telangiectasias (24%), hyperpigmentation (19%), impaired range of motion (33%), and impaired functional use of the extremity (14%); the authors did not identify which complications affected patients with hand or foot lesions and whether certain patients had multiple complications.…”

Section: Discussionmentioning

confidence: 97%

Complications of Radiation Therapy to the Hand After Soft Tissue Sarcoma Surgery

Rohde

Puhaindran

Morris

et al. 2010

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 97%

Complications of Radiation Therapy to the Hand After Soft Tissue Sarcoma Surgery

Rohde

Puhaindran

Morris

et al. 2010

The Journal of Hand Surgery

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“…In a review of 41 adult patients, Jyorthirmaya reported major dysfunction in only 3 patients, partly due to surgery, with no grade 3 toxicity (RTOG criteria) in subcutaneous tissue, bone or joints34. Similarly, a more recent study from the University of Florida reported excellent local control (91%) and maintenance of function in all 21 sarcoma patients following limb-conserving treatment35. Ray resection of the hand, whether border or central, can lead to substantial decrease in grip strength and dexterity36.…”

Section: Discussionmentioning

confidence: 99%

Local Therapy for Rhabdomyosarcoma of the Hands and Feet: Is Amputation Necessary? A Report From the Children's Oncology Group

Wolden

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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Purpose To evaluate the outcome of children with rhabdomyosarcoma (RMS) of the hand or foot treated with surgery and/or local radiotherapy (RT). Methods Forty-eight patients with non-metastatic RMS of the hand or foot were enrolled on Intergroup Rhabdomyosarcoma Study Group III, IV-Pilot, and IV. Patients received multi-agent chemotherapy with surgery and/or RT. Twenty-four patients (50%) underwent surgery without local RT, of whom 4 had complete resection and 20 had an amputation. The remaining 24 patients (50%) underwent local RT, of whom 2 required RT for microscopic residual disease following prior amputation. Median follow-up for surviving patients is 9.7 years. Results Actuarial 10-year local control is 100%; 10-year event-free (EFS) and overall survival (OS) are 62% and 63%, respectively. Poor prognostic factors for recurrence include gross residual (Group III) disease and nodal involvement (p=0.01 and 0.05, respectively). More patients in the RT group had alveolar histology, Group III disease, and nodal involvement, as compared to the surgery group. There is no difference in 10-year EFS (57% vs. 66%) or OS (63% vs. 63%) between patients who underwent surgery or local RT. Among relapsing patients, there are no long-term survivors. No secondary malignancies have been observed. Conclusions Despite having high-risk features, patients treated with local RT achieved excellent local control. Complete surgical resection without amputation is difficult to achieve in the hand or foot. Therefore, we recommend either definitive RT or surgical resection which maintains form and function as primary local therapy rather than amputation in patients with hand or foot rhabdomyosarcoma.

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“…Soft‐tissue spindle cell tumours of extremities represent a therapeutic challenge in terms of achieving local control. In people, soft‐tissue sarcomas are best managed by surgical excision and adjuvant radiation therapy 36–38 . In selected cases, isolated limb perfusion (a technique which delivers chemotherapeutic drugs to specific anatomic sites by isolating the arterial inflow and the venous outflow through an extracorporeal system) is performed, accounting for limb salvage in patients who otherwise would be amputated 39 .…”

Section: Discussionmentioning

confidence: 99%

Postsurgical intra‐incisional 5‐fluorouracil in dogs with incompletely resected, extremity malignant spindle cell tumours: a pilot study

Marconato

Comastri

Lorenzo

et al. 2007

Vet Comparative Oncology

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The safety and efficacy of intra-incisional 5-fluorouracil (5-FU) in the management of incompletely resected malignant spindle cell tumours of extremities was evaluated in six dogs. After marginal surgery, the dogs underwent weekly intra-incisional 5-FU for a minimum of six cycles. Treatment was well tolerated by all dogs, with no systemic adverse effects and only one episode of local cutaneous hyperpigmentation, which completely and spontaneously resolved. Median follow-up for all the dogs was 546 days (mean 619; range 297-1207). At the date of analysis, four dogs were still alive with no evidence of local recurrence, and two dogs had died as a result of their disease. The cause of death was development of distant metastases in one dog and tumour regrowth in the other. Despite the small sample size, this study documents that intra-incisional 5-FU chemotherapy is a safe and efficacious adjuvant treatment in the case of incompletely resected malignant spindle cell tumours in dogs and that long disease control can be achieved.

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Adjuvant radiotherapy in the management of soft tissue sarcoma involving the distal extremities

Cited by 3 publications

References 0 publications

Complications of Radiation Therapy to the Hand After Soft Tissue Sarcoma Surgery

Complications of Radiation Therapy to the Hand After Soft Tissue Sarcoma Surgery

Local Therapy for Rhabdomyosarcoma of the Hands and Feet: Is Amputation Necessary? A Report From the Children's Oncology Group

Postsurgical intra‐incisional 5‐fluorouracil in dogs with incompletely resected, extremity malignant spindle cell tumours: a pilot study

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