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Volume 15, Number 5, 2010

Multimodality treatment of locally advanced soft tissues sarcomas of the extremities.

V. Ravo, I. Marrone, A. Morra, R. Manzo, P. Murino, F. Cammarota, P. Muto


Introduction: Adjuvant radiotherapy (RTE) still has a fundamental role as a postoperative
treatment. In patients with sarcomas of the extremities in whom definitive
surgery has been or not radical (positive or “close” margins), radiotherapy with or
without chemotherapy can improve the results in terms of Disease Free Survival
(DFS) and Overall Survival (OS), while RTE alone seems to improve local control.
Material and Methods: From 1/2000 to 12/2005 we treated 34 patients affected by
locally advanced sarcomas of the upper or lower extremities with radiotherapy (doses
ranging from 54 to 66Gy) and chemotherapy in 18/34 with an adjuvant scheme that
consisted in Epirubicine (120mg/m2) plus Ifosfamide (7000-9000mg/ m2).
Results: Disease Free Survival (DFS) and the Overall Survival (OS) rates were 76%
and 82%, respectively. Eighteen patients developed one or more long-term side
effects. Most of these complications were mild: all patients experienced only
erithema, edema, local sclerosis or moderate pain.
Conclusion: Radiotherapy has an important role as a post-operative treatment also
when surgery was non radical. It improve local control more in patients with highgrade
sarcomas of the extremity with positive or close margins. It is still difficult to
assess the role of adjuvant chemotherapy.

Signature: Rep Pract Oncol Radiother, 2010; 15(5) : 119-124

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