Postoperative Radiotherapy in the Treatment of Soft Tissue Sarcomas

摘要

Seventy four patients with soft tissue sarcomas treated by postoperative radiotherapy in the Department of Therapeutic Radiology, Seoul National University Hospital between August 1979 and September 1990 were analyzed. The follow-up period ranged from 3 to 145 months with a median of 51 months. Liposarcoma and malignant fibrous histiocytoma(MFH) constituted 54% of the cases and the histologic grades of tumors are as follows: grad I, 23 case; grade II, 17 cases; grad III, 24 cases; unknown grade , 10 cases. The patients were treated by marginal(17 cases), wide(55 cases) or compartmental(2 cases) excision followed by postoperative radiotherapy. The total radiation doses were 4200-8820 cGy(median 6000cGy), 180-200n cGy daily, 5 times per week. Of 74 patients, 35 utimately failed. The local control was 62.2% at 5 years and cumulative rik of distant metastasis was 22.3% at 5 years. The overall survival and disease free survival were 72.3% and 53.3% at 5 years, respectively. Survival after appearance of metastasis was 15.1% at 3 yeaers. Patients with liposarcoma experienced better local control that those with other histologic type and tumor grade and surgical resection margin significantly correlated with local recurrence, distant metastasis and overall survival on univeriate analysis. In conclusion, re-excision is needed for patients with positive surgical resection margin to improve local control and further therapeutic measures using effective chemotherapy should be explored in the hope of improving overall survival.