Journal of Clinical Oncology, Vol 14, 859-868, Copyright © 1996 by American Society of Clinical Oncology
Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma
PW Pisters, LB Harrison, DH Leung, JM Woodruff, ES Casper and MF Brennan
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
PURPOSE: This trial was performed to evaluate the impact of adjuvant
brachytherapy on local and systemic recurrence rates in patients with soft
tissue sarcoma. PATIENTS AND METHODS: In a single-institution prospective
randomized trial, 164 patients were randomized intraoperatively to receive
either adjuvant brachytherapy (BRT) or no further therapy (no BRT) after
complete resection of soft tissue sarcomas of the extremity or superficial
trunk. The adjuvant radiation was administered by iridium-192 implant,
which delivered 42 to 45 Gy over 4 to 6 days. The two study groups had
comparable distributions of patient and tumor factors, including age, sex,
tumor site, tumor size, and histologic type and grade. RESULTS: With a
median follow-up time of 76 months, the 5-year actuarial local control
rates were 82% and 69% in the BRT and no BRT groups (P = .04),
respectively. Patients with high- grade lesions had local control rates of
89% (BRT) and 66% (no BRT) (P = .0025). BRT had no impact on local control
in patients with low-grade lesions (P = .49). The 5-year
freedom-from-distant-recurrence rates were 83% and 76% in the BRT and no
BRT groups (P = .60), respectively. Analysis by histologic grade did not
demonstrate an impact of BRT on the development of distant metastasis,
despite the improvement in local control noted in patients with high-grade
lesions. The 5-year disease- specific survival rates for the BRT and no BRT
groups were 84% and 81% (P = .65), respectively, with no impact of BRT
regardless of tumor grade. CONCLUSION: Adjuvant brachytherapy improves
local control after complete resection of soft tissue sarcomas. This
improvement in local control is limited to patients with high-grade
histopathology. The reduction in local recurrence in patients with
high-grade lesions is not associated with a significant reduction in
distant metastasis or improvement in disease-specific survival.
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14(24):
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9(4):
454 - 459.
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14(5):
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|
|
|
|
|
|
|
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|
|
|
|
|
|
|
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14(2):
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|
|
|
|
|
|
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13(10):
1322 - 1328.
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|
|
|
|
|
|
|
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13(4):
508 - 517.
[Abstract]
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[PDF]
|
|
|
|
|
|
|
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13(4):
518 - 524.
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[Full Text]
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|
|
|
|
|
|
|
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24(4):
619 - 625.
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[Full Text]
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|
|
|
|
|
|
|
W. Dziewirski, P. Rutkowski, Z. I. Nowecki, M. Salamacha, T. Morysinski, A. Kulik, M. Kawczynska, A. Kasprowicz, J. Lyczek, and W. Ruka
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13(2):
245 - 252.
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[PDF]
|
|
|
|
|
|
|
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12(11):
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|
|
|
|
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L. A. Mack, P. J. Crowe, J. L. Yang, N. S. Schachar, D. G. Morris, E. C. Kurien, C. L. F. Temple, R. L. Lindsay, E. Magi, W. G. DeHaas, et al.
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|
|
|
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|
|
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|
|
|
|
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|
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23(1):
96 - 104.
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|
|
|
|
|
|
|
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15(11):
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|
|
|
|
|
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40(4):
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|
|
|
|
|
|
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J. Thorac. Cardiovasc. Surg.,
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127(5):
1366 - 1372.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
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CA Cancer J Clin,
March 1, 2004;
54(2):
94 - 109.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
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J. Clin. Oncol.,
August 15, 2003;
21(16):
3092 - 3097.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Weitz, C. R. Antonescu, and M. F. Brennan
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J. Clin. Oncol.,
July 15, 2003;
21(14):
2719 - 2725.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Coleman, M. F. Brennan, K. Alektiar, and P. Russo
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Ann. Surg. Oncol.,
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10(6):
669 - 675.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
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J. Clin. Oncol.,
July 1, 2003;
21(13):
2583 - 2588.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. C. Borden, L. H. Baker, R. S. Bell, V. Bramwell, G. D. Demetri, B. L. Eisenberg, C. D. M. Fletcher, J. A. Fletcher, M. Ladanyi, P. Meltzer, et al.
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June 1, 2003;
9(6):
1941 - 1956.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. H. Segal, P. Pavlidis, W. S. Noble, C. R. Antonescu, A. Viale, U. V. Wesley, K. Busam, H. Gallardo, D. DeSantis, M. F. Brennan, et al.
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J. Clin. Oncol.,
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21(9):
1775 - 1781.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A.M. Davis, B. O'Sullivan, R.S. Bell, R. Turcotte, C.N. Catton, J.S. Wunder, P. Chabot, A. Hammond, V. Benk, M. Isler, et al.
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J. Clin. Oncol.,
November 15, 2002;
20(22):
4472 - 4477.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Stojadinovic, D. H.Y. Leung, P. Allen, J. J. Lewis, D. P. Jaques, and M. F. Brennan
Primary Adult Soft Tissue Sarcoma: Time-Dependent Influence of Prognostic Variables
J. Clin. Oncol.,
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20(21):
4344 - 4352.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. D. Timmerman and K. M. Alektiar
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J. Clin. Oncol.,
September 15, 2002;
20(18):
3929 - 3930.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. I. Spira and D. S. Ettinger
The Use of Chemotherapy in Soft-Tissue Sarcomas
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August 1, 2002;
7(4):
348 - 359.
[Abstract]
[Full Text]
[PDF]
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C.-M. Wendtner, S. Abdel-Rahman, M. Krych, J. Baumert, L. H. Lindner, A. Baur, W. Hiddemann, and R. D. Issels
Response to Neoadjuvant Chemotherapy Combined With Regional Hyperthermia Predicts Long-Term Survival for Adult Patients With Retroperitoneal and Visceral High-Risk Soft Tissue Sarcomas
J. Clin. Oncol.,
July 15, 2002;
20(14):
3156 - 3164.
[Abstract]
[Full Text]
[PDF]
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P. W. T. Pisters, M. T. Ballo, and S. R. Patel
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Ann. Surg. Oncol.,
July 1, 2002;
9(6):
535 - 542.
[Abstract]
[Full Text]
[PDF]
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M. F. Brennan
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May 1, 2002;
9(4):
324 - 325.
[Full Text]
[PDF]
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K. M. Alektiar, D. Leung, M. J. Zelefsky, and M. F. Brennan
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J. Clin. Oncol.,
March 15, 2002;
20(6):
1643 - 1650.
[Abstract]
[Full Text]
[PDF]
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K. M. Alektiar, D. Leung, M. J. Zelefsky, J. H. Healey, and M. F. Brennan
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Ann. Surg. Oncol.,
January 1, 2002;
9(1):
48 - 56.
[Abstract]
[Full Text]
[PDF]
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M. F. Brennan
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Ann. Surg. Oncol.,
July 1, 2001;
8(6):
480 - 481.
[Full Text]
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A. Stojadinovic, D. P. Jaques, D. H. Y. Leung, J. H. Healey, and M. F. Brennan
Amputation for Recurrent Soft Tissue Sarcoma of the Extremity: Indications and Outcome
Ann. Surg. Oncol.,
July 1, 2001;
8(6):
509 - 518.
[Abstract]
[Full Text]
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M. Chun, S. Kang, B.-S. Kim, and Y.-T. Oh
High Dose Rate Interstitial Brachytherapy in Soft Tissue Sarcoma: Technical Aspects and Results
Jpn. J. Clin. Oncol.,
June 1, 2001;
31(6):
279 - 283.
[Abstract]
[Full Text]
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I. Hoeber, A. J. Spillane, C. Fisher, and J. M. Thomas
Accuracy of Biopsy Techniques for Limb and Limb Girdle Soft Tissue Tumors
Ann. Surg. Oncol.,
January 1, 2001;
8(1):
80 - 87.
[Abstract]
[Full Text]
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A. Stojadinovic, A. Hoos, H. M. Karpoff, D. H. Leung, C. R. Antonescu, M. F. Brennan, and J. J. Lewis
Soft Tissue Tumors of the Abdominal Wall: Analysis of Disease Patterns and Treatment
Arch Surg,
January 1, 2001;
136(1):
70 - 79.
[Abstract]
[Full Text]
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A. J. Spillane, R. A'Hern, I. R. Judson, C. Fisher, and J. M. Thomas
Synovial Sarcoma: A Clinicopathologic, Staging, and Prognostic Assessment
J. Clin. Oncol.,
November 15, 2000;
18(22):
3794 - 3803.
[Abstract]
[Full Text]
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J. J. Lewis, C. R. Antonescu, D. H. Y. Leung, D. Blumberg, J. H. Healey, J. M. Woodruff, and M. F. Brennan
Synovial Sarcoma: A Multivariate Analysis of Prognostic Factors in 112 Patients With Primary Localized Tumors of the Extremity
J. Clin. Oncol.,
May 10, 2000;
18(10):
2087 - 2094.
[Abstract]
[Full Text]
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D. C. Linehan, J. J. Lewis, D. Leung, and M. F. Brennan
Influence of Biologic Factors and Anatomic Site in Completely Resected Liposarcoma
J. Clin. Oncol.,
April 1, 2000;
18(8):
1637 - 1643.
[Abstract]
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E. H. Baldini, J. Goldberg, C. Jenner, J. B. Manola, G. D. Demetri, C. D.M. Fletcher, and S. Singer
Long-Term Outcomes After Function-Sparing Surgery Without Radiotherapy for Soft Tissue Sarcoma of the Extremities and Trunk
J. Clin. Oncol.,
October 1, 1999;
17(10):
3252 - 3259.
[Abstract]
[Full Text]
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J. B. Fleming, R. S. Berman, S.-C. Cheng, N. P. Chen, K. K. Hunt, B. W. Feig, P. M. Respondek, A. W. Yasko, A. Pollack, S. R. Patel, et al.
Long-Term Outcome of Patients With American Joint Committee on Cancer Stage IIB Extremity Soft Tissue Sarcomas
J. Clin. Oncol.,
September 1, 1999;
17(9):
2772 - 2772.
[Abstract]
[Full Text]
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