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Adjuvant RT (adjuvant + rt)

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Medical Sciences100%

Selected Abstracts

Influence of compartmental involvement on the patterns of morbidity in soft tissue sarcoma of the thigh

CANCER, Issue 1 2009
Andreas Rimner MD
Abstract BACKGROUD: The authors sought to determine whether differences existed in patterns of outcome and morbidity between the 3 thigh compartments after limb-sparing surgery and postoperative radiation therapy (RT). METHODS: A total of 255 patients with primary soft tissue sarcoma (STS) of the thigh were identified in our sarcoma database (1982,2002). More than 80% of tumors were >5 cm, high grade, and deep; 33% had close or positive microscopic resection margins. Adjuvant RT consisted of brachytherapy alone (BRT; 63%), external beam RT alone (EBRT; 31%), or a combination of brachytherapy and EBRT (6%). There were 125 anterior, 58 medial, and 72 posterior lesions. The 3 compartments were balanced as to tumor grade, size, depth, margin status, and RT type. RESULTS: Overall local control (LC) was 89%, distant metastases-free survival (DMFS) was 61%, and overall survival (OS) was 66% at 5 years (median follow-up, 71 months). Overall rates for complications at 5 years were wound reoperation (10%), edema (13%), joint stiffness (12%), nerve damage (8%), and bone fractures (7%). Wound reoperation and edema were significantly higher for medial-compartment tumors (P = .01 and .005, respectively), whereas nerve damage occurred more frequently in posterior-compartment tumors (P < .001). There were no differences among bone fracture, joint stiffness, DMFS, or OS rates between compartments. CONCLUSIONS: Although tumor control was similar for all 3 compartments, more wound reoperation and edema were observed in the medial compartment, and more nerve damage was noted in the posterior compartment. These results may help guide decisions concerning current patients and improve the design of future treatments tailored to compartments. Cancer 2009. © 2008 American Cancer Society. [source]

Adjuvant radiotherapy in the treatment of pediatric myxopapillary ependymomas,,

PEDIATRIC BLOOD & CANCER, Issue 4 2010
Hani Al-Halabi MD
Abstract Objectives Assess the role of radiotherapy (RT) in the management of primary and recurrent myxopapillary ependymoma (MPE). Materials and Methods We conducted a retrospective review of patients with MPE treated at the Montreal Children's Hospital/McGill University Health Centre between 1985 and 2008. Results Seven children under the age of 18 were diagnosed and treated for MPE. All patients were treated with surgery to the primary site. Three patients underwent subtotal resection (STR) and received adjuvant post-operative RT. Only one patient who had spinal drop metastases received post-operative RT to the lumbosacral region following complete resection of the primary tumor. After a median follow up of 78 months (range 24,180 months), all patients were alive with controlled disease. The single patient treated with gross total resection (GTR) and adjuvant local radiation remained recurrence free. One of the three patients treated with STR and adjuvant RT had disease progression that was controlled with re-resection and further RT. Two of the three patients treated with surgery alone developed local and disseminated recurrent spinal disease that was controlled by salvage RT. Conclusion Our data support the evolving literature which suggests that GTR alone provides suboptimal disease control in MPE. In our patients, RT resulted in control of residual, metastatic and/or recurrent disease. Routine adjuvant RT may improve outcomes in pediatric MPE. Pediatr Blood Cancer. 2010;55:639,643. © 2010 Wiley-Liss, Inc. [source]

Evidence supports adjuvant radiotherapy in selected patients with rectal cancer

ANZ JOURNAL OF SURGERY, Issue 3 2004
Peter Gibbs
Background: Much recent data have been published on the risk of local recurrence (LR) following curative surgery for rectal cancer and the impact of adjuvant radiation therapy (RT). With improvements in surgical technique apparently reducing the risk of LR, the relevance of older data upon which the current recommendations for adjuvant RT are based has been questioned. Methods: A focused review was undertaken of the published literature on the risk of LR following surgery for rectal cancer and the impact of adjuvant radiation. In particular the authors attempt to define how accurately the risk for an individual patient can be predicted, trends in reported LR rates over the time period of randomized trials, and the relevance of changing surgical and RT techniques. Results: Many of the perceived differences in published results can be explained by variations in study entry criteria, length of follow up and data recording. Comparisons between studies are most accurate when defined subsets of patients, such as those with stage III disease, followed for the same period of time, are considered. In parallel with improvements in surgical technique, which may have reduced the risk of LR, modifications to RT delivery have resulted in recent series not reporting an increased mortality in those patients treated with modern RT techniques. Conclusion: All of the available evidence supports the use of adjuvant RT in selected patients with rectal cancer. Ongoing studies will better define individual patient risk and the risk,benefit ratio of adjuvant RT. [source]