Efficacy and Safety of Adjuvant Radiotherapy in Re-excised Soft-tissue Sarcoma After Unplanned Resection - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Oncologist Année : 2023

Efficacy and Safety of Adjuvant Radiotherapy in Re-excised Soft-tissue Sarcoma After Unplanned Resection

Floriane Izarn
Isabelle Ray-Coquard
Jean-Yves Blay
Armelle Dufresne
Mehdi Brahmi
Amine Bouhamama
Pierre Meeus
Gualter Vaz
Francois Gouin
Marie Karanian
Coralie Moncharmont
Waisse Waissi
Marie-Pierre Sunyach

Résumé

Introduction: The objective of this study was to evaluate the efficacy and safety of adjuvant radiotherapy (aRT) in patients with soft-tissue sarcoma (STS) re-excised after unplanned tumor resection (UPR). Materials and Methods: From 2000 to 2015, we retrospectively evaluated patients with STS of limb or trunk who underwent post-UPR re-excision in our expert center and received or not aRT. Results: Median follow-up was 121 months (IQR 94-165). Among the 145 patients, 37 were not treated with aRT (no-RT) and 108 received aRT with a median radiation dose of 50 Gy (IQR 50-60). At 10 years, patients in the aRT and no-RT groups showed a cumulative incidence of local failure (10y-LF) of 14.7% and 37.7%, and a local recurrence-free survival (10y-LRFS) of 61.3% and 45.8%, respectively. Multivariate analysis identified aRT and age ≥70 years as independent predictors of both LF and LRFS, while grade 3 and deep-seated tumor were independent predictors of LRFS. In overall population, 10-year distant metastasis-free survival (10y-DMFS) and overall survival (10y-OS) were 63.7% and 69.4%. In multivariate analyses, age ≥70 years, grade 3, and deep-seated lesion were associated with shorter DMFS and OS. Acute severe adverse events were not significantly increased in aRT group (14.8% vs. 18.1%, P = .85) but dramatically increased if radiation dose exceeded 50 Gy (risk ratio 2.96 compared to ≤50 Gy, P = .04). Conclusion: In STS patients re-excised after UPR, 50 Gy aRT was safe and associated with reduced LF and longer LRFS. It seems to be beneficial even in absence of residual disease or in absence of initial adverse prognostic factors.
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hal-04155328 , version 1 (07-07-2023)

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Benoît Allignet, Paul Pou, Floriane Izarn, Isabelle Ray-Coquard, Jean-Yves Blay, et al.. Efficacy and Safety of Adjuvant Radiotherapy in Re-excised Soft-tissue Sarcoma After Unplanned Resection. Oncologist, 2023, 28 (7), pp.633 - 639. ⟨10.1093/oncolo/oyad076⟩. ⟨hal-04155328⟩
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