Interval between surgery and radiotherapy: Effect on local control of soft tissue sarcoma

Matthew Ballo, Gunar K. Zagars, Janice N. Cormier, Kelly K. Hunt, Barry W. Feig, Shreyaskumar R. Patel, Peter W.T. Pisters

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Purpose To evaluate the clinical significance of the interval between surgery and postoperative radiotherapy (RT) for patients with soft tissue sarcoma. Methods and materials The records of 799 patients who underwent postoperative RT for soft tissue sarcoma between 1960 and 2000 were retrospectively reviewed. Univariate and multivariate analyses were used to evaluate the potential impact of the timing of postoperative RT on the rate of local control (LC). Results The actuarial overall LC rate was 79% at 10 years and 78% at 15 years. Univariate analysis indicated that the factors associated with an inferior 10-year LC rate were positive resection margins (p <0.0001) ; treatment for recurrent disease (p <0.0001); primary location in the head and neck or deep trunk (p <0.0001); age >64 years (p <0.0001); histopathologic subtype of malignant fibrous histiocytoma, neurogenic sarcoma, or epithelioid sarcoma (p = 0.01); tumor size >10 cm (p = 0.02); postoperative radiation dose <64 Gy (p = 0.03); and high histologic grade (p = 0.05). On multivariate analysis, all these factors remained statistically significant, except for high histologic grade and large size. A delay between surgery and the start of RT of >30 days was associated with a decreased 10-year LC rate, but this association was not statistically significant (76% vs. 83%, p = 0.07). The potential association between RT delay and inferior LC could be explained by an imbalance in the distribution of other prognostic factors. Conclusion The interval between surgery and RT did not significantly impact the 10-year LC rate. These findings indicate that an RT delay should not be viewed as an independent adverse factor for LC and that treatment intensification may not be necessary for patients in whom a treatment delay has already occurred.

Original languageEnglish (US)
Pages (from-to)1461-1467
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume58
Issue number5
DOIs
StatePublished - Apr 1 2004

Fingerprint

surgery
Sarcoma
radiation therapy
Radiotherapy
cancer
intervals
Statistical Factor Analysis
Multivariate Analysis
margins
Radiation
time measurement
dosage
Therapeutics
radiation

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Interval between surgery and radiotherapy : Effect on local control of soft tissue sarcoma. / Ballo, Matthew; Zagars, Gunar K.; Cormier, Janice N.; Hunt, Kelly K.; Feig, Barry W.; Patel, Shreyaskumar R.; Pisters, Peter W.T.

In: International Journal of Radiation Oncology Biology Physics, Vol. 58, No. 5, 01.04.2004, p. 1461-1467.

Research output: Contribution to journalArticle

Ballo, Matthew ; Zagars, Gunar K. ; Cormier, Janice N. ; Hunt, Kelly K. ; Feig, Barry W. ; Patel, Shreyaskumar R. ; Pisters, Peter W.T. / Interval between surgery and radiotherapy : Effect on local control of soft tissue sarcoma. In: International Journal of Radiation Oncology Biology Physics. 2004 ; Vol. 58, No. 5. pp. 1461-1467.
@article{feec85854b3e4def90d19a06589dd6fb,
title = "Interval between surgery and radiotherapy: Effect on local control of soft tissue sarcoma",
abstract = "Purpose To evaluate the clinical significance of the interval between surgery and postoperative radiotherapy (RT) for patients with soft tissue sarcoma. Methods and materials The records of 799 patients who underwent postoperative RT for soft tissue sarcoma between 1960 and 2000 were retrospectively reviewed. Univariate and multivariate analyses were used to evaluate the potential impact of the timing of postoperative RT on the rate of local control (LC). Results The actuarial overall LC rate was 79{\%} at 10 years and 78{\%} at 15 years. Univariate analysis indicated that the factors associated with an inferior 10-year LC rate were positive resection margins (p <0.0001) ; treatment for recurrent disease (p <0.0001); primary location in the head and neck or deep trunk (p <0.0001); age >64 years (p <0.0001); histopathologic subtype of malignant fibrous histiocytoma, neurogenic sarcoma, or epithelioid sarcoma (p = 0.01); tumor size >10 cm (p = 0.02); postoperative radiation dose <64 Gy (p = 0.03); and high histologic grade (p = 0.05). On multivariate analysis, all these factors remained statistically significant, except for high histologic grade and large size. A delay between surgery and the start of RT of >30 days was associated with a decreased 10-year LC rate, but this association was not statistically significant (76{\%} vs. 83{\%}, p = 0.07). The potential association between RT delay and inferior LC could be explained by an imbalance in the distribution of other prognostic factors. Conclusion The interval between surgery and RT did not significantly impact the 10-year LC rate. These findings indicate that an RT delay should not be viewed as an independent adverse factor for LC and that treatment intensification may not be necessary for patients in whom a treatment delay has already occurred.",
author = "Matthew Ballo and Zagars, {Gunar K.} and Cormier, {Janice N.} and Hunt, {Kelly K.} and Feig, {Barry W.} and Patel, {Shreyaskumar R.} and Pisters, {Peter W.T.}",
year = "2004",
month = "4",
day = "1",
doi = "10.1016/j.ijrobp.2003.09.079",
language = "English (US)",
volume = "58",
pages = "1461--1467",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Interval between surgery and radiotherapy

T2 - Effect on local control of soft tissue sarcoma

AU - Ballo, Matthew

AU - Zagars, Gunar K.

AU - Cormier, Janice N.

AU - Hunt, Kelly K.

AU - Feig, Barry W.

AU - Patel, Shreyaskumar R.

AU - Pisters, Peter W.T.

PY - 2004/4/1

Y1 - 2004/4/1

N2 - Purpose To evaluate the clinical significance of the interval between surgery and postoperative radiotherapy (RT) for patients with soft tissue sarcoma. Methods and materials The records of 799 patients who underwent postoperative RT for soft tissue sarcoma between 1960 and 2000 were retrospectively reviewed. Univariate and multivariate analyses were used to evaluate the potential impact of the timing of postoperative RT on the rate of local control (LC). Results The actuarial overall LC rate was 79% at 10 years and 78% at 15 years. Univariate analysis indicated that the factors associated with an inferior 10-year LC rate were positive resection margins (p <0.0001) ; treatment for recurrent disease (p <0.0001); primary location in the head and neck or deep trunk (p <0.0001); age >64 years (p <0.0001); histopathologic subtype of malignant fibrous histiocytoma, neurogenic sarcoma, or epithelioid sarcoma (p = 0.01); tumor size >10 cm (p = 0.02); postoperative radiation dose <64 Gy (p = 0.03); and high histologic grade (p = 0.05). On multivariate analysis, all these factors remained statistically significant, except for high histologic grade and large size. A delay between surgery and the start of RT of >30 days was associated with a decreased 10-year LC rate, but this association was not statistically significant (76% vs. 83%, p = 0.07). The potential association between RT delay and inferior LC could be explained by an imbalance in the distribution of other prognostic factors. Conclusion The interval between surgery and RT did not significantly impact the 10-year LC rate. These findings indicate that an RT delay should not be viewed as an independent adverse factor for LC and that treatment intensification may not be necessary for patients in whom a treatment delay has already occurred.

AB - Purpose To evaluate the clinical significance of the interval between surgery and postoperative radiotherapy (RT) for patients with soft tissue sarcoma. Methods and materials The records of 799 patients who underwent postoperative RT for soft tissue sarcoma between 1960 and 2000 were retrospectively reviewed. Univariate and multivariate analyses were used to evaluate the potential impact of the timing of postoperative RT on the rate of local control (LC). Results The actuarial overall LC rate was 79% at 10 years and 78% at 15 years. Univariate analysis indicated that the factors associated with an inferior 10-year LC rate were positive resection margins (p <0.0001) ; treatment for recurrent disease (p <0.0001); primary location in the head and neck or deep trunk (p <0.0001); age >64 years (p <0.0001); histopathologic subtype of malignant fibrous histiocytoma, neurogenic sarcoma, or epithelioid sarcoma (p = 0.01); tumor size >10 cm (p = 0.02); postoperative radiation dose <64 Gy (p = 0.03); and high histologic grade (p = 0.05). On multivariate analysis, all these factors remained statistically significant, except for high histologic grade and large size. A delay between surgery and the start of RT of >30 days was associated with a decreased 10-year LC rate, but this association was not statistically significant (76% vs. 83%, p = 0.07). The potential association between RT delay and inferior LC could be explained by an imbalance in the distribution of other prognostic factors. Conclusion The interval between surgery and RT did not significantly impact the 10-year LC rate. These findings indicate that an RT delay should not be viewed as an independent adverse factor for LC and that treatment intensification may not be necessary for patients in whom a treatment delay has already occurred.

UR - http://www.scopus.com/inward/record.url?scp=1842424399&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1842424399&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2003.09.079

DO - 10.1016/j.ijrobp.2003.09.079

M3 - Article

C2 - 15050324

AN - SCOPUS:1842424399

VL - 58

SP - 1461

EP - 1467

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 5

ER -