Clinical practice guideline: 2006 update of recommendations for the radiotherapeutic management of patients with soft tissue sarcoma (sarcoma of the extremity, uterin sarcoma and retroperitoneal sarcoma);Recommandations pour la pratique clinique: Mise à jour 2006 des Standards, Options et Recommandations pour l'irradiation des patientsadultes atteints de sarcome des tissus mous (sarcomes des membres, sarcomes rétropéritonéaux et sarcomes utérins)

Cancer/Radiotherapie

Volumn 10, Issue 4, 2006, Pages 185-207

  Le Pechoux C ^a   Pautier, P ^a   Delannes, M ^b   Bui, B N ^c   Blay, J Y ^d   Bonichon, F ^c   Bonvalot, S ^a   Chevalier Place, A ^e   Coindre, J M ^c   Le Cesne, A ^a   Morice, P ^a   Ray Coquard, I ^f   Stoeckle E ^c   Taieb, S ^e  

^a INSTITUT GUSTAVE ROUSSY   (France)

^b INSTITUT CLAUDIUS REGAUD   (France)

^c INSTITUT BERGONIÉ   (France)

^d EDOUARD HERRIOT HOSPITAL   (France)

^e CENTRE OSCAR LAMBRET   (France)

^f CENTRE LÉON BÉRARD   (France)

Author keywords

Adult; Brachytherapy; Clinical practice guidelines; Radiotherapy; Retroperitoneal soft tissue sarcoma; Soft tissue sarcoma of the extremity; Uterin soft tissue sarcoma

Indexed keywords

ADJUVANT THERAPY; ARM; ARTICLE; BRACHYTHERAPY; FEMALE; FRANCE; HUMAN; LEG; PRACTICE GUIDELINE; RADIATION DOSE; RADIATION EXPOSURE; RETROPERITONEAL TUMOR; SARCOMA; SOFT TISSUE TUMOR; TUMOR RECURRENCE; UTERUS CANCER;

BRACHYTHERAPY; FEMALE; FRANCE; HUMANS; LOWER EXTREMITY; NEOADJUVANT THERAPY; NEOPLASM RECURRENCE, LOCAL; RADIOTHERAPY DOSAGE; RADIOTHERAPY, ADJUVANT; RETROPERITONEAL NEOPLASMS; SARCOMA; SOFT TISSUE NEOPLASMS; UPPER EXTREMITY; UTERINE NEOPLASMS;

EID: 33748097846     PISSN: 12783218     EISSN: 17696658     Source Type: Journal    
DOI: 10.1016/j.canrad.2006.04.001     Document Type: Article

References (152)

1. Abbatucci JS, Boulier N, de Ranieri J, Mandard AM, Tanguy A, Vernhes JC, et al. Local control and survival in soft tissue sarcomas of the limbs, trunk walls and head and neck: a study of 113 cases. Int J Radiat Oncol Biol Phys 1986;12:579-86.
2. Alekhteyar KM, Leung DH, Brennan MF, Harrison LB. The effect of combined external beam radiotherapy and brachytherapy on local control and wound complications in patients with high-grade soft tissue sarcomas of the extremity with positive microscopic margin. Int J Radiat Oncol Biol Phys 1996;36:321-4.
3. Alektiar KM, Leung D, Zelefsky MJ, Healey JH, Brennan MF. Adjuvant brachytherapy for primary high-grade soft tissue sarcoma of the extremity Ann Surg Oncol 2002;9:48-56.
4. Alektiar KM, Velasco J, Zelefsky MJ, Woodruff JM, Lewis JJ, Brennan MF. Adjuvant radiotherapy for margin-positive high-grade soft tissue sarcoma of the extremity. Int J Radiat Oncol Biol Phys 2000;48:1051-8.
5. Alektiar KM, Zelefsky MJ, Brennan MF. Morbidity of adjuvant brachytherapy in soft tissue sarcoma of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys 2000;47:1273-9.
6. Andem (Agence nationale pour le développement de lévaluation médicale). Usage thérapeutique des cyclotrons en cancérologie: évaluation clinique et économique. 1995.
7. Arbeit JM, Hilaris BS, Brennan MF. Wound complications in the multimodality treatment of extremity and superficial truncal sarcomas. J Clin Oncol 1987;5:480-8.
8. Avizonis VN, Sause WT, Menlove RL. Utility of surgical margins in the radiotherapeutic management of soft tissue sarcomas. J Surg Oncol 1990;45:85-90.
9. Baldini EH, Goldberg J, Jenner C, Manola JB, Demetri GD, Fletcher CD, et al. Long-term outcomes after function-sparing surgery without radiotherapy for soft tissue sarcoma of the extremities and trunk. J Clin Oncol 1999;17:3252-9.
10. Bell RS, Mahoney J, O'Sullivan B, Nguyen C, Langer F, Cummings B, et al. Wound healing complications in soft tissue sarcoma management: comparison of three treatment protocols. J Surg Oncol 1991;46:190-7.
11. Bell RS, O'Sullivan B, Davis A, Langer F, Cummings B, Fornasier VL. Functional outcome in patients treated with surgery and irradiation for soft tissue tumours. J Surg Oncol 1991;48:224-31.
12. Bell RS, O'Sullivan B, Langer F, Mahoney JL, Lichtenstein SV, Moffat FL, et al. Complications and functional results after limb-salvage surgery and radiotherapy for difficult mesenchymal neoplasms: a prospective analysis. Can J Surg 1989;32:69-73.
13. Bevilacqua RG, Rogatko A, Hajdu SI, Brennan MF. Prognostic factors in primary retroperitoneal soft-tissue sarcomas. Arch Surg 1991;126:328-34.
14. Brémond A, Bataillard A, Thomas L, Achard JL, Fervers B, Fondrinier E, et al. Fédération nationale des centres de lutte contre le cancer, ed. Cancer de lendomètre. Stades non métastatiques. Paris: John Libbey Eurotext; 2001. Standards, Options & Recommandations, vol. 11.
15. Brizel DM, Scully SP, Harrelson JM, Layfield LJ, Dodge RK, Charles HC, et al. Radiation therapy and hyperthermia improve the oxygenation of human soft tissue sarcomas. Cancer Res 1996;56:5347-50.
16. Bui BN, Blay JY, Bonichon F, Busson A, Carrie C, Chauvel P, et al. Prise en charge des patients adultes atteints de sarcomes des tissus mous. In: Fédération nationale des centres de lutte contre le cancer, ed. Sarcomes des tissus mous et ostéosarcomes. Paris: Arnette Blackwell; 1995. p. 1-113. Standards, Options & Recommandations, vol 1.
17. Bui BN, Blay JY, Bonichon F, Busson A, Carrie C, Chauvel P, et al. Standards, options et recommandations pour la prise en charge des patients adultes atteints de sarcomes des tissus mous. In: Fédération nationale des centres de lutte contre le cancer, ed. Recommandations pour la pratique clinique en cancérologie [Cédérom]. 2 ed. Paris: FNCLCC, John Libbey Eurotext; 1998. Standards, Options & Recommandations.
18. Bujko K, Suit HD, Springfield DS, Convery K. Wound healing after preoperative radiation for sarcoma of soft tissues. Surg Gynecol Obstet 1993;176:124-34.
19. Catton CN, O'Sullivan B, Kotwall C, Cummings B, Hao Y, Fornasier V. Outcome and prognosis in retroperitoneal soft tissue sarcoma. Int J Radiat Oncol Biol Phys 1994;29:1005-10.
20. Chauveinc L, Deniaud E, Plancher C, Sastre X, Amsani F, de la RA, et al. Uterine sarcomas: the Curie Institut experience. Prognosis factors and adjuvant treatments. Gynecol Oncol 1999;72:232-7.
21. Cheng EY, Dusenbery KE, Winters MR, Thompson RC. Soft tissue sarcomas: preoperative vs postoperative radiotherapy. J Surg Oncol 1996;61:90-9.
22. Chi DS, Mychalczak B, Saigo PE, Rescigno J, Brown CL. The role of whole-pelvic irradiation in the treatment of early-stage uterine carcinosarcoma. Gynecol Oncol 1997;65:493-8.
23. Choong PF, Petersen IA, Nascimento AG, Sim FH. Is radiotherapy important for low-grade soft tissue sarcoma of the extremity? Clin Orthop 2001;191-9.
24. Cohen L, Hendrickson F, Mansell J, Kurup PD, Awschalom M, Rosenberg I, et al. Response of sarcomas of bone and of soft tissue to neutron beam therapy. Int J Radiat Oncol Biol Phys 1984;10:821-4.
25. Coindre JM, Terrier P, Bui NB, Bonichon F, Collin F, Le Doussal V, et al. Prognostic factors in adult patients with locally controlled soft tissue sarcoma. A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group. J Clin Oncol 1996;14:869-77.
26. Collin CF, Friedrich C, Godbold J, Hajdu S, Brennan MF. Prognostic factors for local recurrence and survival in patients with localized extremity soft-tissue sarcoma. Semin Surg Oncol 1988;4:30-7.
27. Cormier JN, Patel SR, Herzog CE, Ballo MT, Burgess MA, Feig BW, et al. Concurrent ifosfamide-based chemotherapy and irradiation. Analysis of treatment-related toxicity in 43 patients with sarcoma. Cancer 2001;92:1550-5.
28. Costa J, Wesley RA, Glatstein E, Rosenberg SA. The grading of soft tissue sarcomas. Results of a clinicohistopathologic correlation in a series of 163 cases. Cancer 1984;53:530-41.
29. Dalton RR, Lanciano RM, Hoffman JP, Eisenberg BL. Wound complications after resection and immediate postoperative brachytherapy in the management of soft-tissue sarcomas. Ann Surg Oncol 1996;3:51-6.
30. Davis AM, O'Sullivan B, Bell RS, Turcotte R, Catton CN, Wunder JS, et al. Function and health status outcomes in a randomized trial comparing preoperative and postoperative radiotherapy in extremity soft tissue sarcoma. J Clin Oncol 2002;20:4472-7.
31. Delannes M, Thomas L, Martel P, Bonnevialle P, Stoeckle E, Chevreau C, et al. Low-dose-rate intraoperative brachytherapy combined with external beam irradiation in the conservative treatment of soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2000;47:165-9.
32. Donohue JH, Collin C, Friedrich C, Godbold J, Hajdu SI, Brennan MF. Low-grade soft tissue sarcomas of the extremities. Analysis of risk factors for metastasis. Cancer 1988;62:184-93.
33. Duncan W, Arnott SJ, Jack WJ. The Edinburgh experience of treating sarcomas of soft tissues and bone with neutron irradiation. Clin Radiol 1986;37:317-20.
34. Echt G, Jepson J, Steel J, Langholz B, Luxton G, Hernandez W, et al. Treatment of uterine sarcomas. Cancer 1990;66:35-9.
35. Eilber F, Eckardt J, Rosen G, Forscher C, Selch M, Fu YS. Preoperative therapy for soft tissue sarcoma. Hematol Oncol Clin North Am 1995;9:817-23.
36. Enneking WF. Musculoskeletal tmor surgery. New York: Churchill Livingstone; 1983.
37. Evans GR, Black JJ, Robb GL, Baldwin BJ, Kroll SS, Miller MJ, et al. Adjuvant therapy: the effects on microvascular lower extremity reconstruction. Ann Plast Surg 1997;39:141-4.
38. Fabrizio PL, Stafford SL, Pritchard DJ. Extremity soft-tissue sarcomas selectively treated with surgery alone. Int J Radiat Oncol Biol Phys 2000;48:227-32.
39. Fein DA, Lee WR, Lanciano RM, Corn BW, Herbert SH, Hanlon AL, et al. Management of extremity soft tissue sarcomas with limb-sparing surgery and postoperative irradiation: do total dose, overall treatment time, and the surgery-radiotherapy interval impact on local control? Int J Radiat Oncol Biol Phys 1995;32:969-76.
40. Ferrer F, Sabater S, Farrus B, Guedea F, Rovirosa A, Anglada L, et al. Impact of radiotherapy on local control and survival in uterine sarcomas: a retrospective study from the Grup Oncologic Catala-Occita. Int J Radiat Oncol Biol Phys 1999;44:47-52.
41. Fervers B, Bonichon F, Demard F, Heron JF, Mathoulin S, Philip T, et al. Méthodologie de développement des Standards, Options et Recommandations diagnostiques et thérapeutiques en cancérologie. Bull Cancer 1995;82:761-7.
42. Fervers B, Hardy J, Blanc-Vincent MP, Theobald S, Bataillard A, Farsi F, et al. SOR: project methodology. Br J Cancer 2001;84:8-16.
43. Fleming JB, Berman RS, Cheng SC, Chen NP, Hunt KK, Feig BW, et al. Long-term outcome of patients with American Joint Committee on Cancer stage IIB extremity soft tissue sarcomas [Comment in: J Clin Oncol 2000 Apr;18(8):1800-1.]. J Clin Oncol 1999;17:2772-80.
44. Frezza G, Barbieri E, Ammendolia I, Corsa P, Neri S, Putti C, et al. Surgery and radiation therapy in the treatment of soft tissue sarcomas of extremities. Ann Oncol 1992;3 Suppl 2:S93-S95.
45. Gaynor JJ, Tan CC, Casper ES, Collin CF, Friedrich C, Shiu M, et al. Refinement of clinicopathologic staging for localized soft tissue sarcoma of the extremity: a study of 423 adults. J Clin Oncol 1992;10:1317-29.
46. Geer RJ, Woodruff J, Casper ES, Brennan MF. Management of small soft-tissue sarcoma of the extremity in adults [Comment in: Arch Surg 1993 Dec;128(12):1399.]. Arch Surg 1992;127:1285-9.
47. Gerszten K, Faul C, Kounelis S, Huang Q, Kelley J, Jones MW. The impact of adjuvant radiotherapy on carcinosarcoma of the uterus. Gynecol Oncol 1998;68:8-13.
48. Gieschen HL, Spiro IJ, Suit HD, Ott MJ, Rattner DW, Ancukiewicz M, et al. Long-term results of intraoperative electron beam radiotherapy for primary and recurrent retroperitoneal soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2001;50:127-31.
49. Gilbeau L, Kantor G, Stoeckle E, Lagarde P, Thomas L, Kind M, et al. Surgical resection and radiotherapy for primary retroperitoneal soft tissue sarcoma [Comment on: Radiother. Oncol. 2002 Dec; 65(3):133-6.]. Radiother Oncol 2002;65:137-43.
50. Glenn J, Sindelar WF, Kinsella T, Glatstein E, Tepper J, Costa J, et al. Results of multimodality therapy of resectable soft-tissue sarcomas of the retroperitoneum. Surgery 1985;97:316-25.
51. Guillou L, Coindre JM. Facteurs pronostiques des sarcomes des tissus mous de ladulte. Ann Pathol 1997;17:375-7.
52. Habrand JL, Gerbaulet A, Pejovic MH, Contesso G, Durand S, Haie C, et al. Twenty years experience of interstitial iridium brachytherapy in the management of soft tissue sarcomas. Int J Radiat Oncol Biol Phys 1991;20:405-11.
53. Harrison LB, Franzese F, Gaynor J J, Zelefsky M J, Armstrong J, Fass D. et al. Results of a prospective randomized trial of adjuvant brachytherapy in the managment of completely resected soft-tissue sarcoma. Proceeding of teh 34th annual ASTRO meeting. Int J Radiat Oncol Biol Phys 1992;24(suppl1):240.
54. Healey EA, Shamberger RC, Grier HE, Loeffler JS, Tarbell NJ. A 10-year experience of pediatric brachytherapy. Int J Radiat Oncol Biol Phys 1995;32:451-5.
55. Herbert SH, Corn BW, Solin LJ, Lanciano RM, Schultz DJ, McKenna WG, et al. Limb-preserving treatment for soft tissue sarcomas of the extremities. The significance of surgical margins. Cancer 1993;72:1230-8.
56. Heslin MJ, Lewis JJ, Nadler E, Newman E, Woodruff JM, Casper ES, et al. Prognostic factors associated with long-term survival for retroperitoneal sarcoma: implications for management. J Clin Oncol 1997;15:2832-9.
57. Hilaris BS, Bodner WR, Mastoras CA. Role of brachytherapy in adult soft tissue sarcomas. Semin Surg Oncol 1997;13:196-203.
58. Hoffmann W, Schmandt S, Kortmann RD, Schiebe M, Dietl J, Bamberg M. Radiotherapy in the treatment of uterine sarcomas. A retrospective analysis of 54 cases. Gynecol Obstet Invest 1996;42:49-57.
59. Holt GE, Griffin AM, Pintilie M, Wunder JS, Catton C, O'Sullivan B, et al. Fractures following radiotherapy and limb-salvage surgery for lower extremity soft-tissue sarcomas. A comparison of high-dose and low-dose radiotherapy. J Bone Joint Surg Am 2005;87:315-9.
60. Hornback NB, Omura G, Major FJ. Observations on the use of adjuvant radiation therapy in patients with stage I and II uterine sarcoma. Int J Radiat Oncol Biol Phys 1986;12:2127-30.
61. ICRU, International Comission on Radiation Units and Measurements. ICRU Report 50: prescribing, recording and reporting photon beam therapy Bethesda 1993.
62. Jones JJ, Catton CN, O'Sullivan B, Couture J, Heisler RL, Kandel RA, et al. Initial results of a trial of preoperative external-beam radiation therapy and postoperative brachytherapy for retroperitoneal sarcoma [Comment in: Ann Surg Oncol 2002 May;9(4):324-5.]. Ann Surg Oncol 2002;9:346-54.
63. Karakousis CP, Emrich LJ, Rao U, Krishnamsetty RM. Feasibility of limb salvage and survival in soft tissue sarcomas. Cancer 1986;57:484-91.
64. Keus RB, Rutgers EJ, Ho GH, Gortzak E, Albus-Lutter CE, Hart AA. Limb-sparing therapy of extremity soft tissue sarcomas: treatment outcome and long-term functional results. Eur J Cancer 1994;30A:1459-63.
65. Khanfir K, Alzieu L, Terrier P, Le Pechoux C, Bonvalot S, Vanel D, et al. Does adjuvant radiation therapy increase loco-regional control after optimal resection of soft-tissue sarcoma of the extremities? Eur J Cancer 2003;39:1872-80.
66. Kraybill WG, Harris J, Spiro IJ, Ettinger DS, DeLaney TF, Blum RH, et al. Phase II study of neoadjuvant chemotherapy and radiation therapy in the management of high-risk, high-grade, soft tissue sarcomas of the extremities and body wall: Radiation Therapy Oncology Group Trial 9514 [Comment in: J Clin Oncol 2006 Feb 1;24(4):549-51.]. J Clin Oncol 2006;24:619-25.
67. Kraybill WG, Spiro JJ, Harris JA, Ettinger D, Trotti A, Lucas D, et al. A phase II study of neoadjuvant chemotherapy (CT) and radiation therapy (RT) in the management of high risk (HR), high grade, soft tissue sarcomas (STS) of the extremities and body wall. Proc Am Soc Clin Oncol 2003;20(abstr 3276).
68. Lagarde P, Kantor G, Bussieres E, Stockle E, Coindre JM, Tramond P, et al. Radiothérapie postopératoire des sarcomes des parties molles des membres. Analyse des volumes et des doses dirradiation sur une série de 31 cas. Bull Cancer Radiother 1990;77:101-9.
69. Langlois D, Bey P, Luporsi E, Hofsetter S, Marchal C, Malissard L. Radiothérapie des sarcomes des parties molles: place et résultats. Bull Cancer Radiother 1991;78:39-49.
70. Lartigau E, Kantor G, Taieb S, Vilain MO, Ceugnart L, Lagarde P, et al. Définition des volumes-cibles dans les sarcomes des tissus mous des extrémités. Cancer Radiother 2001;5:695-703.
71. Le Pechoux C, Le Deley MC, Delaloge S, Lartigau E, Levy-Piedbois C, Bonvalot S, et al. Postoperative radiotherapy in the management of adult soft tissue sarcoma of the extremities: results with two different total dose, fractionation, and overall treatment time schedules. Int J Radiat Oncol Biol Phys 1999;44:879-86.
72. Leibel SA, Tranbaugh RF, Wara WM, Beckstead JH, Bovill EG, Phillips TL. Soft tissue sarcomas of the extremities: survival and patterns of failure with conservative surgery and postoperative irradiation compared to surgery alone. Cancer 1982;50:1076-83.
73. LeVay J, O'Sullivan B, Catton C, Bell R, Fornasier V, Cummings B, et al. Outcome and prognostic factors in soft tissue sarcoma in the adult. Int J Radiat Oncol Biol Phys 1993;27:1091-9.
74. Lewis JJ, Leung D, Espat J, Woodruff JM, Brennan MF. Effect of reresection in extremity soft tissue sarcoma. Ann Surg 2000;231:655-63.
75. Lewis JJ, Leung D, Heslin M, Woodruff JM, Brennan MF. Association of local recurrence with subsequent survival in extremity soft tissue sarcoma. J Clin Oncol 1997;15:646-52.
76. Lindberg RD. Soft-tissue sarcoma. In: Fletcher GH, ed. Textbook of radiotherapy. Philadelphia: Lea & Febiger; 1980;922-42.
77. Lindberg RD, Martin RG, Romsdahl MM, Barkley HT Jr. Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer 1981;47:2391-7.
78. Mandard AM, Petiot JF, Marnay J, Mandard JC, Chasle J, de Ranieri E, et al. Prognostic factors in soft tissue sarcomas. A multivariate analysis of 109 cases. Cancer 1989;63:1437-51.
79. Marcus SG, Merino MJ, Glatstein E, DeLaney TF, Steinberg SM, Rosenberg SA, et al. Long-term outcome in 87 patients with low-grade soft-tissue sarcoma. Arch Surg 1993;128:1336-43.
80. Markhede G, Angervall L, Stener B. A multivariate analysis of the prognosis after surgical treatment of malignant soft-tissue tumors. Cancer 1982;49:1721-33.
81. McGrath PC, Neifeld JP, Lawrence W Jr., DeMay RM, Kay S, Horsley JS, III, et al. Improved survival following complete excision of retroperitoneal sarcomas. Ann Surg 1984;200:200-4.
82. Mills EE, Hering ER. Management of soft tissue tumours by limited surgery combined with tumour bed irradiation using brachytherapy and supplementary teletherapy. Br J Radiol 1981;54:312-7.
83. Moureau L, Thomas L, Bui N, Chevreau C, Stoeckle E, Martel P, et al. Management of soft tissue sarcomas in first isolated local recurrence: a retrospective study of 83 cases. Int J Radiat Oncol Biol Phys 2002;54:342.
84. Mundt AJ, Awan A, Sibley GS, Simon M, Rubin SJ, Samuels B, et al. Conservative surgery and adjuvant radiation therapy in the management of adult soft tissue sarcoma of the extremities: clinical and radiobiological results. Int J Radiat Oncol Biol Phys 1995;32:977-85.
85. Nag S, Martinez-Monge R, Ruymann F, Jamil A, Bauer C. Innovation in the management of soft tissue sarcomas in infants and young children: high-dose-rate brachytherapy. J Clin Oncol 1997;15:3075-84.
86. Nag S, Shasha D, Janjan N, Petersen I, Zaider M. The American Brachytherapy Society recommendations for brachytherapy of soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2001;49:1033-43.
87. Nori D, Schupak K, Shiu MH, Brennan MF, Shupak K. Role of brachytherapy in recurrent extremity sarcoma in patients treated with prior surgery and irradiation [Erratum in: Int J Radiat Oncol Biol Phys 1991 Nov;21(6):1683. Shupak K[corrected to Schupak K]]. Int J Radiat Oncol Biol Phys 1991;20:1229-33.
88. O'Connor MI, Pritchard DJ, Gunderson LL. Integration of limb-sparing surgery, brachytherapy, and external-beam irradiation in the treatment of soft-tissue sarcomas. Clin Orthop 1993;73-80.
89. O'Sullivan B, Davis AM, Turcotte R, Bell R, Catton C, Chabot P, et al. Preoperative vs postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomised trial [Comment in: Lancet. 2002 Dec 14; 360(9349): 1988; author reply 1989; Comment in: Lancet. 2002 Dec 14; 360(9349): 1989; author reply 1989]. Lancet 2002; 359: 2235-41.
90. Olieman AF, Pras E, van Ginkel RJ, Molenaar WM, Schraffordt KH, Hoekstra HJ. Feasibility and efficacy of external beam radiotherapy after hyperthermic isolated limb perfusion with TNF-alpha and melphalan for limb-saving treatment in locally advanced extremity soft-tissue sarcoma. Int J Radiat Oncol Biol Phys 1998;40:807-14.
91. Panchal JI, Agrawal RK, McLean NR, Dawes PJ. Early post-operative brachytherapy and free flap reconstruction in the management of sarcomas. Eur J Surg Oncol 1996;22:144-6.
92. Pao WJ, Pilepich MV. Postoperative radiotherapy in the treatment of extremity soft tissue sarcomas. Int J Radiat Oncol Biol Phys 1990;19:907-11.
93. Peat BG, Bell RS, Davis A, O'Sullivan B, Mahoney J, Manktelow RT, et al. Wound-healing complications after soft-tissue sarcoma surgery. Plast Reconstr Surg 1994;93:980-7.
94. Pelton JG, Del Rowe JD, Bolen JW, Russell AH, Laramore GE, Griffin TW, et al. Fast neutron radiotherapy for soft tissue sarcomas. University of Washington experience and review of the worlds literature. Am J Clin Oncol 1986;9:397-400.
95. Pickering DG, Stewart JS, Rampling R, Errington RD, Stamp G, Chia Y. Fast neutron therapy for soft tissue sarcoma. Int J Radiat Oncol Biol Phys 1987;13:1489-95.
96. Pisters PW, Ballo MT, Patel SR. Preoperative chemoradiation treatment strategies for localized sarcoma. Ann Surg Oncol 2002;9:535-42.
97. Pisters PW, Harrison LB, Leung DH, Woodruff JM, Casper ES, Brennan MF. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol 1996;14:859-68.
98. Pisters PW, Harrison LB, Woodruff JM, Gaynor JJ, Brennan MF. A prospective randomized trial of adjuvant brachytherapy in the management of low-grade soft tissue sarcomas of the extremity and superficial trunk. J Clin Oncol 1994;12:1150-5.
99. Pisters PW, Leung DH, Woodruff J, Shi W, Brennan MF. Analysis of prognostic factors in 1,041 patients with localized soft tissue sarcomas of the extremities. J Clin Oncol 1996;14:1679-89.
100. Pollack A, Zagars GK, Goswitz MS, Pollock RA, Feig BW, Pisters PW. Preoperative vs postoperative radiotherapy in the treatment of soft tissue sarcomas: a matter of presentation. Int J Radiat Oncol Biol Phys 1998;42:563-72.
101. Potter DA, Kinsella T, Glatstein E, Wesley R, White DE, Seipp CA, et al. High-grade soft tissue sarcomas of the extremities. Cancer 1986;58:190-205.
102. Prosnitz LR, Maguire P, Anderson JM, Scully SP, Harrelson JM, Jones EL, et al. The treatment of high-grade soft tissue sarcomas with preoperative thermoradiotherapy. Int J Radiat Oncol Biol Phys 1999;45:941-9.
103. Ravaud A, Bui NB, Coindre JM, Lagarde P, Tramond P, Bonichon F, et al. Prognostic variables for the selection of patients with operable soft tissue sarcomas to be considered in adjuvant chemotherapy trials. Br J Cancer 1992;66:961-9.
104. Rhomberg W, Hassenstein EO, Gefeller D. Radiotherapy vs. radiotherapy and razoxane in the treatment of soft tissue sarcomas: final results of a randomized study. Int J Radiat Oncol Biol Phys 1996;36:1077-84.
105. Richard F, Renard L, Wambersie A. Current results of neutron therapy at the UCL, for soft tissue sarcomas and prostatic adenocarcinomas. Universite Catholique de Louvain. Bull Cancer 1986;73:562-8.
106. Robinson M, Barr L, Fisher C, Fryatt I, Stotter A, Harmer C, et al. Treatment of extremity soft tissue sarcomas with surgery and radiotherapy. Radiother Oncol 1990;18:221-33.
107. Rose PG, Boutselis JG, Sachs L. Adjuvant therapy for stage I uterine sarcoma. Am J Obstet Gynecol 1987;156:660-2.
108. Rosenberg SA, Glatstein EJ. Perspectives on the role of surgery and radiation therapy in the treatment of soft tissue sarcomas of the extremities. Semin Oncol 1981;8:190-200.
109. Rosenberg SA, Tepper J, Glatstein E, Costa J, Baker A, Brennan M, et al. The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing surgery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg 1982;196:305-15.
110. Ruka W, Emrich LJ, Driscoll DL, Karakousis CP. Clinical factors and treatment parameters affecting prognosis in adult high-grade soft tissue sarcomas: a retrospective review of 267 cases. Eur J Surg Oncol 1989;15:411-23.
111. Rydholm A, Gustafson P, Rooser B, Willen H, Akerman M, Herrlin K, et al. Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma. J Clin Oncol 1991;9:1757-65.
112. Sadoski C, Suit HD, Rosenberg A, Mankin H, Efird J. Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues. J Surg Oncol 1993;52:223-30.
113. Salinas R, Hussey DH, Fletcher GH, Lindberg RD, Martin RG, Peters LJ, et al. Experience with neutron therapy for locally advanced sarcomas. Int J Radiat Oncol Biol Phys 1980;6:267-72.
114. Sastre-Garau X, Coindre JM, Leroyer A, Terrier P, Ollivier L, Stockle E, et al. Predictive factors for complete removal in soft tissue sarcomas: a retrospective analysis in a series of 592 cases. J Surg Oncol 1997;65:175-82.
115. Sauer R, Schuchardt U, Hohenberger W, Wittekind C, Papadopoulos T, Grabenbauer GG, et al. [Neoadjuvant radiochemotherapy in soft tissue sarcomas. Optimization of local functional tumor control]. Strahlenther Onkol 1999;175:259-66.
116. Schmitt G, Mills EE, Levin V, Pape H, Smit BJ, Zamboglou N. The role of neutrons in the treatment of soft tissue sarcomas. Cancer 1989;64:2064-8.
117. Schray MF, Gunderson LL, Sim FH, Pritchard DJ, Shives TC, Yeakel PD. Soft tissue sarcoma. Integration of brachytherapy, resection, and external irradiation. Cancer 1990;66:451-6.
118. Schwartz DL, Einck J, Bellon J, Laramore GE. Fast neutron radiotherapy for soft tissue and cartilaginous sarcomas at high risk for local recurrence. Int J Radiat Oncol Biol Phys 2001;50:449-6.
119. Schwarz R, Krull A, Lessel A, Engenhart-Cabillic R, Favre A, Prott FJ, et al. European results of neutron therapy in soft tissue sarcomas. Recent Results Cancer Res 1998;150:100-12.
120. Serpell JW, Ball AB, Robinson MH, Fryatt I, Fisher C, Thomas JM. Factors influencing local recurrence and survival in patients with soft tissue sarcoma of the upper limb. Br J Surg 1991;78:1368-72.
121. Shimm DS, Bell DA, Fuller AF, Bowling MC, Orlow EL, Munzenrider JE, et al. Sarcomas of the uterine corpus: prognostic factors and treatment. Radiother Oncol 1984;2:201-7.
122. Shiu MH, Hilaris BS, Harrison LB, Brennan MF. Brachytherapy and function-saving resection of soft tissue sarcoma arising in the limb. Int J Radiat Oncol Biol Phys 1991;21:1485-92.
123. Sindelar WF, Kinsella TJ, Chen PW, DeLaney TF, Tepper JE, Rosenberg SA, et al. Intraoperative radiotherapy in retroperitoneal sarcomas. Final results of a prospective, randomized, clinical trial. Arch Surg 1993;128:402-10.
124. Singer S, Corson JM, Demetri GD, Healey EA, Marcus K, Eberlein TJ. Prognostic factors predictive of survival for truncal and retroperitoneal soft-tissue sarcoma. Ann Surg 1995;221:185-95.
125. Singer S, Corson JM, Gonin R, Labow B, Eberlein TJ. Prognostic factors predictive of survival and local recurrence for extremity soft tissue sarcoma [Comment in: Ann Surg 1995 Feb;221(2):203-5.]. Ann Surg 1994;219:165-73.
126. Skibber JM, Lotze MT, Seipp CA, Salcedo R, Rosenberg SA. Limb-sparing surgery for soft tissue sarcomas: wound related morbidity in patients undergoing wide local excision. Surgery 1987;102:447-52.
127. Sondak VK, Robertson JM, Sussman JJ, Saran PA, Chang AE, Lawrence TS. Preoperative idoxuridine and radiation for large soft tissue sarcomas: clinical results with five-year follow-up. Ann Surg Oncol 1998;5:106-12.
128. Stinson SF, DeLaney TF, Greenberg J, Yang JC, Lampert MH, Hicks JE, et al. Acute and long-term effects on limb function of combined modality limb sparing therapy for extremity soft tissue sarcoma. Int J Radiat Oncol Biol Phys 1991;21:1493-9.
129. Stoeckle E, Coindre JM, Bonvalot S, Kantor G, Terrier P, Bonichon F, et al. Prognostic factors in retroperitoneal sarcoma: a multivariate analysis of a series of 165 patients of the French Cancer Center Federation Sarcoma Group Cancer 2001;92:359-68.
130. Stotter AT, A'Hern RP, Fisher C, Mott AF, Fallowfield ME, Westbury G. The influence of local recurrence of extremity soft tissue sarcoma on metastasis and survival. Cancer 1990;65:1119-29.
131. Suit H. Tumors of the connective and supporting tissues. Radiother Oncol 1995;34:93-104.
132. Suit HD, Mankin HJ, Wood WC, Gebhardt MC, Harmon DC, Rosenberg A, et al. Treatment of the patient with stage M0 soft tissue sarcoma. J Clin Oncol 1988;6:854-62.
133. Suit HD, Mankin HJ, Wood WC, Proppe KH. Preoperative, intraoperative, and postoperative radiation in the treatment of primary soft tissue sarcoma. Cancer 1985;55:2659-67.
134. Suit HD, Russell WO. Soft part tumors. Cancer 1977;39:830-6.
135. Tanabe KK, Pollock RE, Ellis LM, Murphy A, Sherman N, Romsdahl MM. Influence of surgical margins on outcome in patients with preoperatively irradiated extremity soft tissue sarcomas. Cancer 1994;73:1652-9.
136. Tepper J, Rosenberg SA, Glatstein E. Radiation therapy technique in soft tissue sarcomas of the extremity. Policies of treatment at the National Cancer Institute. Int J Radiat Oncol Biol Phys 1982;8:263-73.
137. Tepper JE, Suit HD. Radiation therapy alone for sarcoma of soft tissue. Cancer 1985;56:475-9.
138. Thijssens KM, van Ginkel RJ, Pras E, Suurmeijer AJ, Hoekstra HJ. Isolated limb perfusion with tumor necrosis factor alpha and melphalan for locally advanced soft tissue sarcoma: the value of adjuvant radiotherapy. Ann Surg Oncol 2006;13:518-24.
139. Thomas L, Bataillard A, Bremond A, Fondrinier E, Fervers B, Achard JL, et al. Standards, Options et Recommandations pour la radiothérapie des patientes atteintes de cancer de lendomètre. Cancer Radiother 2001;5:163-92.
140. Thomas L, Delannes M, Stockle E, Martel P, Bui BN, Daly-Schveitzer N, et al. Intraoperative interstitial iridium brachytherapy in the managementof soft tissue sarcomas: preliminary results of a feasibility phase II study. Radiother Oncol 1994;33:99-105.
141. Tinkler SD, Cowie VJ. Uterine sarcomas: a review of the Edinburgh experience from 1974 to 1992. Br J Radiol 1993;66:998-1001.
142. Todoroki T, Suit HD. Effect of fractionated irradiation prior to conservative and radical surgery on therapeutic gain in a spontaneous fibrosarcoma of the C3H mouse. J Surg Oncol 1986;31:279-86.
143. van Doorn RC, Gallee MP, Hart AA, Gortzak E, Rutgers EJ, van Coevorden F, et al. Resectable retroperitoneal soft tissue sarcomas. The effect of extent of resection and postoperative radiation therapy on local tumor control. Cancer 1994;73:637-42.
144. Vraa S, Keller J, Nielsen OS, Sneppen O, Jurik AG, Jensen OM. Prognostic factors in soft tissue sarcomas: the Aarhus experience. Eur J Cancer 1998;34:1876-82.
145. Weingrad DN, Rosenberg SA. Early lymphatic spread of osteogenic and soft-tissue sarcomas. Surgery 1978;84:231-40.
146. Wiklund TA, Alvegard TA, Mouridsen HT, Rydholm A, Blomqvist CP. Marginal surgery and postoperative radiotherapy in soft tissue sarcomas. The Scandinavian Sarcoma Group experience. Eur J Cancer 1993;29A:306-9.
147. Wilson AN, Davis A, Bell RS, O'Sullivan B, Catton C, Madadi F, et al. Local control of soft tissue sarcoma of the extremity: the experience of a multidisciplinary sarcoma group with definitive surgery and radiotherapy. Eur J Cancer 1994;30A:746-51.
148. Wolfson AH, Benedetto PW, Mnaymneh W, Moffat FL, Robinson DS, Boyer C, et al. Does a radiation dose-response relation exist concerning survival of patients who have soft-tissue sarcomas of the extremities? Radiation dose-response relation for soft-tissue sarcomas. Am J Clin Oncol 1998;21:270-4.
149. Wood WC, Suit HD, Mankin HJ, Cohen AM, Proppe K. Radiation and conservative surgery in the treatment of soft tissue sarcoma. Am J Surg 1984;147:537-41.
150. Yang JC, Chang AE, Baker AR, Sindelar WF, Danforth DN, Topalian SL, et al. Randomized prospective study of the benefit of adjuvant radiation therapy in the treatment of soft tissue sarcomas of the extremity. J Clin Oncol 1998;16:197-203.
151. Zagars GK, Ballo MT, Pisters PW, Pollock RE, Patel SR, Benjamin RS. Surgical margins and reresection in the management of patients with soft tissue sarcoma using conservative surgery and radiation therapy. Cancer 2003;97:2544-53.
152. Zelefsky MJ, Nori D, Shiu MH, Brennan MF. Limb salvage in soft tissue sarcomas involving neurovascular structures using combined surgical resection and brachytherapy. Int J Radiat Oncol Biol Phys 1990;19:913-8.