Radiation Therapy: Neoadjuvant, Adjuvant, or Not at All

Surgical Oncology Clinics of North America

Volumn 21, Issue 2, 2012, Pages 215-241

  DeLaney, Thomas F ^a,b  

^a HARVARD MEDICAL SCHOOL   (United States)

^b MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

Adjuvant; Neoadjuvant; Radiation therapy; Soft tissue sarcoma

Indexed keywords

CISPLATIN; DACARBAZINE; DOXORUBICIN; IDOXURIDINE; IFOSFAMIDE; MESNA; TRABECTEDIN;

ADJUVANT THERAPY; ADVANCED CANCER; BRACHYTHERAPY; CANCER ADJUVANT THERAPY; CANCER COMBINATION CHEMOTHERAPY; CANCER CONTROL; CANCER LOCALIZATION; CANCER MORTALITY; CANCER RADIOTHERAPY; CANCER RECURRENCE; CANCER SIZE; CANCER SURVIVAL; CHEMOTHERAPY INDUCED EMESIS; CONSERVATIVE TREATMENT; DRUG SAFETY; EXTERNAL BEAM RADIOTHERAPY; FOOT CANCER; FOOT DISEASE; FUNCTIONAL STATUS; HAND TUMOR; HUMAN; INTENSITY MODULATED RADIATION THERAPY; LIMB MOVEMENT; LIMB SALVAGE; PATIENT SELECTION; POSTOPERATIVE CARE; PREOPERATIVE TREATMENT; PROTON THERAPY; RADIATION DOSE; RETROPERITONEAL SARCOMA; REVIEW; RISK REDUCTION; SOFT TISSUE SARCOMA; SURGICAL APPROACH; TREATMENT INDICATION; TREATMENT OUTCOME; TREATMENT PLANNING; TREATMENT RESPONSE; WOUND COMPLICATION;

ANTIBIOTICS, ANTINEOPLASTIC; BRACHYTHERAPY; DOXORUBICIN; HUMANS; MAGNETIC RESONANCE IMAGING; NEOADJUVANT THERAPY; NEOPLASM RECURRENCE, LOCAL; PATIENT SELECTION; PREOPERATIVE CARE; PROTONS; RADIOTHERAPY DOSAGE; RADIOTHERAPY PLANNING, COMPUTER-ASSISTED; RADIOTHERAPY, ADJUVANT; RADIOTHERAPY, INTENSITY-MODULATED; RETROPERITONEAL NEOPLASMS; SARCOMA; SOFT TISSUE NEOPLASMS; TOMOGRAPHY, X-RAY COMPUTED; WOUND HEALING;

EID: 84857412239     PISSN: 10553207     EISSN: 15585042     Source Type: Journal    
DOI: 10.1016/j.soc.2011.12.005     Document Type: Review

References (115)

1. Kepka L., DeLaney T.F., Goldberg S.I., et al. Results of radiation therapy for unresected soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2005, 63:852.
2. Baldini E.H., Goldberg J., Jenner C., et al. Long-term outcomes after functon-sparing surgery without radiotherapy for soft tissue sarcoma of the extemities and trunk. J Clin Oncol 1999, 17:3252.
3. White L.M., Wunder J.S., Bell R.S., et al. Histologic assessment of peritumoral edema in soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2005, 61:1439.
4. Markhede G., Angervall L., Stener B. A multivariate analysis of the prognosis after surgical treatment of malignant soft-tissue tumors. Cancer 1982, 49:1721.
5. Pisters P.W., Harrison L.B., Leung D.H., et al. Long-term results of a prospective randomized trial of adjuvant brachytherapy in soft tissue sarcoma. J Clin Oncol 1996, 14:859.
6. Yang J.C., Chang A.E., Baker A.R., 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.
7. O'Sullivan B., Davis A.M., Turcotte R., et al. Preoperative versus postoperative radiotherapy in soft-tissue sarcoma of the limbs: a randomized trial. Lancet 2002, 359:2235.
8. Davis A.M., O'Sullivan B., Turcotte R., et al. Late radiation morbidity following randomization to preoperative versus postoperative radiotherapy in extremity soft tissue sarcoma. Radiother Oncol 2005, 75:48.
9. Alektiar K.M., Brennan M.F., Healey J.H., et al. Impact of intensity-modulated radiation therapy on local control in primary soft-tissue sarcoma of the extremity. J Clin Oncol 2008, 26:3440.
10. Griffin A.M., Euler C.I., Sharpe M.B., et al. Radiation planning comparison for superficial tissue avoidance in radiotherapy for soft tissue sarcoma of the lower extremity. Int J Radiat Oncol Biol Phys 2007, 67:847.
11. Yoon S.S., Chen Y.L., Kirsch D.G., et al. Proton-beam, intensity-modulated, and/or intraoperative electron radiation therapy combined with aggressive anterior surgical resection for retroperitoneal sarcomas. Ann Surg Oncol 2010, 17:1515.
12. Gustafson P., Dreinhofer K.E., Rydholm A. Soft tissue sarcoma should be treated at a tumor center. A comparison of quality of surgery in 375 patients. Acta Orthop Scand 1994, 65:47.
13. Simon M.A., Enneking W.F. The management of soft-tissue sarcomas of the extremities. J Bone Joint Surg Am 1976, 58:317.
14. Rosenberg S.A., Tepper J., Glatstein E., 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. Rydholm A., Berg N.O., Gullber B., et al. Epidemiology of soft tissue sarcoma in the locomotor system. Acta Pathol Microbiol Immunol Scand A 1984, 92:363.
16. Lindberg R.D., Martin R.G., Romsdahl M.M., et al. Conservative surgery and postoperative radiotherapy in 300 adults with soft-tissue sarcomas. Cancer 1981, 47:2391.
17. Suit H.D., Russell W.O., Martin R.G. Sarcoma of soft tissue: clinical and histopathologic parameters and response to treatment. Cancer 1975, 35:1478.
18. Abbatucci J.S., Boulier N., de Ranieri J., 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.
19. Brant T.A., Parsons J.T., Marcus R.B., et al. Preoperative irradiation for soft tissue sarcomas of the trunk and extremities in adults. Int J Radiat Oncol Biol Phys 1990, 19.
20. DeLaney T.F., Spiro I.J., Suit H.D., et al. Neoadjuvant chemotherapy and radiotherapy for large extremity soft-tissue sarcomas. Int J Radiat Oncol Biol Phys 2003, 56:1117.
21. Eilber F.R., Eckardt J. Surgical management of soft tissue sarcomas. Semin Oncol 1997, 24:526.
22. Harrison L.B., Franzese F., Gaynor J.J., et al. Long-term results of a prospective randomized trial of adjuvant brachytherapy in the management of completely resected soft tissue sarcomas of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys 1993, 27:259.
23. Karakousis C.P., Emrich L.J., Rao U., et al. Feasibility of limb salvage and survival in soft tissue sarcomas. Cancer 1986, 57:484.
24. Potter D.A., Glenn J., Kinsella T., et al. Patterns of recurrence in patients with high-grade soft tissue sarcomas. J Clin Oncol 1985, 3:353.
25. Wilson A.N., Davis A., Bell R.S., 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.
26. Karakousis C.P., Driscoll D.L. Treatment and local control of primary extremity soft tissue sarcomas. J Surg Oncol 1999, 71:155.
27. LeVay J., O'Sullivan B., Catton C., et al. Outcome and prognostic factors in soft tissue sarcoma in the adult. Int J Radiat Oncol Biol Phys 1993, 27:1091.
28. Williard W.C., Hajdu S.I., Casper E.S., et al. Comparison of amputation with limb-sparing operations for adult soft tissue sarcoma of the extremity. Ann Surg 1992, 215:389.
29. Rydholm A., Gustafson P., Rooser B., et al. Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma. J Clin Oncol 1991, 9:1757.
30. Pisters P.W., Pollock R.E., Lewis V.O., et al. Long-term results of prospective trial of surgery alone with selective use of radiation for patients with T1 extremity and trunk soft tissue sarcomas. Ann Surg 2007, 246:675.
31. Ruka W., Taghian A., Gioioso D., et al. Comparison between the in vitro intrinsic radiation sensitivity of human soft tissue sarcoma and breast cancer cell lines. J Surg Oncol 1996, 61:290.
32. Tepper J.E., Suit H.D. Radiation therapy alone for sarcoma of soft tissue. Cancer 1985, 56:475.
33. Todoroki T., Suit H.D. Therapeutic advantage in preoperative single-dose radiation combined with conservative and radical surgery in different-size murine fibrosarcomas. J Surg Oncol 1985, 29:207.
34. O'Sullivan B., Davis A., Bell R., et al. Phase III randomized trial of pre-operative versus post-operative radiotherapy in the curative management of extremity soft tissue sarcoma. A Canadian Sarcoma Group and NCI Canada Clinical Trials Group study. Proc Am Soc Clin Oncol 1999, 18:2066a.
35. Davis A.M., O'Sullivan B., Bell R.S., 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.
36. O'Sullivan B., Davis A.M., Turcotte R., et al. Five-year results of a randomized phase III trial of pre-operative vs. post-operative radiotherapy in extremity soft tissue sarcoma. Proc Am Soc Clin Oncol 2004, 23:815.
37. Schray M.F., Gunderson L.L., Sim F.H., et al. Soft tissue sarcomas. Integration of brachytherapy, resection, and external irradiation. Cancer 1990, 66:451.
38. Alektiar K.M., Zelefsky M.J., Brennan M.F. Morbidity of adjuvant brachytherapy in soft tissue sarcoma of the extremity and superficial trunk. Int J Radiat Oncol Biol Phys 2000, 47:1273.
39. Panagopoulos I., Hoglund M., Mertens F., et al. Fusion of EWS and CHOP genes in myxoid liposarcoma. Oncogene 1996, 12:489.
40. Alektiar K.M., Brennan M.F., Singer S. Local control comparison of adjuvant brachytherapy to intensity-modulated radiotherapy in primary high-grade sarcoma of the extremity. Cancer 2011, 117:3229.
41. Kretzler A., Molls M., Gradinger R., et al. Intraoperative radiotherapy of soft tissue sarcoma of the extremity. Perioperative fractionated high-dose rate brachytherapy in the treatment of soft tissue sarcomas. Strahlenther Onkol 2004, 180:365.
42. Nag S., Shasha D., Janjan N., et al. The American Brachytherapy Society recommendations for brachytherapy of soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2001, 49:1033.
43. Petera J., Neumanova R., Odrazka K., et al. Perioperative fractionated high-dose rate brachytherapy in the treatment of soft tissue sarcomas. Neoplasma 2004, 51:59.
44. Beltrami G., Rudiger H.A., Mela M.M., et al. Limb salvage surgery in combination with brachytherapy and external beam radiation for high-grade soft tissue sarcomas. Eur J Surg Oncol 2008, 34:811.
45. Tepper J., Rosenberg S.A., 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.
46. Suit H.D., Mankin H.J., Wood W.C., et al. Treatment of the patient with stage M0 sarcoma of soft tissue. J Clin Oncol 1988, 6:854.
47. Mundt A.J., Awan A., Sibley G.S., 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.
48. Cleator S.J., Cottril C., Harmer C. Pattern of local recurrence after conservative surgery and radiotherapy for soft tissue sarcoma. Sarcoma 2001, 5:83.
49. Kim B., Chen Y.L., Kirsch D.G., et al. An effective preoperative three-dimensional radiotherapy target volume for extremity soft tissue sarcoma and the effect of margin width on local control. Int J Radiat Oncol Biol Phys 2010, 77:843.
50. Haglund K.E., Raut C.P., Nascimento A.F., et al. Recurrence patterns and survival for ptients with Intermediate- and high-grade myxofibrosarcoma. Int J Radiat Oncol Biol Phys 2012, 82:361.
51. Sadoski C., Suit H.D., Rosenberg A., et al. Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues. J Surg Oncol 1993, 52:223.
52. Al Yami A., Griffin A.M., Ferguson P.C., et al. Positive surgical margins in soft tissue sarcoma treated with preoperative radiation: is a postoperative boost necessary?. Int J Radiat Oncol Biol Phys 2010, 77:1191.
53. Zagars G.K., Ballo M.T. Significance of dose in postoperative radiotherapy for soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2003, 56:473.
54. Fein D.A., Lee W.R., Lanciano R.M., 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.
55. Bell R.S., O'Sullivan B., Liu F.F., et al. The surgical margin in soft tissue sarcoma. J Bone Joint Surg Am 1989, 71:370.
56. Pao W.J., Pilepich M.V. Postoperative radiotherapy in the treatment of extremity soft tissue sarcomas. Int J Radiat Oncol Biol Phys 1990, 19:907.
57. Robinson M., Barr L., Fisher C., et al. Treatment of extremity soft tissue sarcomas with surgery and radiotherapy. Radiother Oncol 1990, 18:221.
58. Robinson M.H., Ball A.B., Schofield J., et al. Preoperative radiotherapy for initially inoperable extremity soft tissue sarcomas. Clin Oncol (R Coll Radiol) 1992, 4:36.
59. Stinson S.F., DeLaney T.F., Greenberg J., et al. Acute and long term effects on limb function of combined modality limb sparing therapy for extremity soft tissue sarcomas. Int J Radiat Oncol Biol Phys 1991, 21:1493.
60. Verhey L.J. Comparison of three-dimensional conformal radiation therapy and intensity-modulated radiation therapy systems. Semin Radiat Oncol 1999, 9:78.
61. Chan M.F., Chui C.S., Schupak K., et al. The treatment of large extraskeletal chondrosarcoma of the leg: comparison of IMRT and conformal radiotherapy techniques. J Appl Clin Med Phys 2001, 2:3.
62. Hong L., Alektiar K.M., Hunt M., et al. Intensity-modulated radiotherapy for soft tissue sarcoma of the thigh. Int J Radiat Oncol Biol Phys 2004, 59:752.
63. Lee N., Chuang C., Quivey J.M., et al. Skin toxicity due to intensity-modulated radiotherapy for head-and-neck carcinoma. Int J Radiat Oncol Biol Phys 2002, 53:630.
64. Austin-Seymour M., Munzenrider J., Goitein M., et al. Fractionated proton radiation therapy of chordoma and low grade chondrosarcoma of the base of skull. J Neurosurg 1989, 70:13.
65. Wilson R.R. Radiological uses of fast protons. Radiology 1946, 47:487.
66. Eilber F.C., Rosen G., Eckardt J., et al. Treatment-induced pathologic necrosis: a predictor of local recurrence and survival in patients receiving neoadjuvant therapy for high-grade extremity soft tissue sarcomas. J Clin Oncol 2001, 19:3203.
67. Wanebo H.J., Temple W.J., Popp M.B., et al. Preoperative regional therapy for extremity sarcoma. A tricenter update. Cancer 1995, 75:2299.
68. Eilber F., Eckardt J., Rosen G., et al. Preoperative therapy for soft tissue sarcoma. Hematol Oncol Clin North Am 1995, 9:817.
69. Merimsky O., Meller I., Issakov J., et al. Adriamycin-ifosfamide induction chemotherapy for extremity soft tissue sarcoma: comparison of two non-randomized protocols. Oncol Rep 1999, 6:913.
70. Kraybill W.G., Harris J., Spiro I.J., 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. J Clin Oncol 2006, 24:619.
71. Bramwell V. The role of chemotherapy in the management of non-metastatic operable extremity osteosarcoma. Semin Oncol 1997, 24:561.
72. Crist W.M., Anderson J.R., Meza J.L., et al. Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease. J Clin Oncol 2001, 19:3091.
73. Rosen G., Caparros B., Nirenberg A., et al. Ewing's sarcoma: ten-year experience with adjuvant chemotherapy. Cancer 1981, 47:2204.
74. Antman K.H. Adjuvant therapy of sarcomas of soft tissue. Semin Oncol 1997, 24:556.
75. Scurr M., Judson I. Neoadjuvant and adjuvant therapy for extremity soft tissue sarcomas. Hematol Oncol Clin North Am 2005, 19:489.
76. Pisters P.W., Ballo M.T., Fenstermacher M.J., et al. Phase I trial of preoperative concurrent doxorubicin and radiation therapy, surgical resection, and intraoperative electron-beam radiation therapy for patients with localized retroperitoneal sarcoma. J Clin Oncol 2003, 21:3092.
77. Johnstone P.A., Wexler L.H., Venzon D.J., et al. Sarcomas of the hand and foot: analysis of local control and functional result with combined modality therapy in extremity preservation. Int J Radiat Oncol Biol Phys 1994, 29:735.
78. Karakousis C.P., De Young C., Driscoll D.L. Soft tissue sarcomas of the hand and foot: management and survival. Ann Surg Oncol 1998, 5:238.
79. Pradhan A., Cheung Y.C., Grimer R.J., et al. Soft-tissue sarcomas of the hand: oncological outcome and prognostic factors. J Bone Joint Surg Br 2008, 90:209.
80. Talbert M.L., Zagars G.K., Sherman N.E., et al. Conservative surgery and radiation therapy for soft tissue sarcoma of the wrist, hand, ankle, and foot. Cancer 1990, 66:2482.
81. Bujko K., Suit H.D., Springfield D.S., et al. Wound healing after surgery and preoperative radiation for sarcoma of soft tissues. Surg Gynecol Obstet 1992, 176:124.
82. Tseng J.F., Ballo M.T., Langstein H.N., et al. The effect of preoperative radiotherapy and reconstructive surgery on wound complications after resection of extremity soft-tissue sarcomas. Ann Surg Oncol 2006, 13:1209.
83. Arbeit J.M., Hilaris B., Brennan M.F. Wound complications in the multimodality treatment of extremity and superficial truncal sarcomas. J Clin Oncol 1987, 5:480.
84. Davis A.M., Devlin M., Griffin A.M., et al. Functional outcome in amputation versus limb sparing of patients with lower extremity sarcoma: a matched case-control study. Arch Phys Med Rehabil 1999, 80:615.
85. Robinson M.H., Spruce L., Eeles R., et al. Limb function following conservation treatment of adult soft tissue sarcoma. Eur J Cancer 1991, 27:1567.
86. Gerrand C.H., Wunder J.S., Kandel R.A., et al. The influence of anatomic location on functional outcome in lower-extremity soft-tissue sarcoma. Ann Surg Oncol 2004, 11:476.
87. Aksnes L.H., Bauer H.C., Jebsen N.L., et al. Limb-sparing surgery preserves more function than amputation: a Scandinavian sarcoma group study of 118 patients. J Bone Joint Surg Br 2008, 90:786.
88. Sugarbaker P.H., Barofsky I., Rosenberg S.A., et al. Quality of life assessment of patients in extremity sarcoma clinical trials. Surgery 1982, 91:17.
89. Weddington W.W., Segraves K.B., Simon M.A. Psychological outcome of extremity sarcoma survivors undergoing amputation or limb salvage. J Clin Oncol 1985, 3:1393.
90. Zagars G.K., Ballo M.T., Pisters P.W., et al. Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy: an analysis of 1225 patients. Cancer 2003, 97:2530.
91. Catton C., Davis A., Bell R., et al. Soft tissue sarcoma of the extremity. Limb salvage after failure of combined conservative therapy. Radiother Oncol 1996, 41:209.
92. Karakousis C.P., Proimakis C., Rao U., et al. Local recurrence and survival in soft-tissue sarcomas. Ann Surg Oncol 1996, 3:255.
93. Ueda T., Yoshikawa H., Mori S., et al. Influence of local recurrence on the prognosis of soft-tissue sarcomas. J Bone Joint Surg Br 1997, 79:553.
94. Pearlstone D.B., Janjan N.A., Feig B.W., et al. Re-resection with brachytherapy for locally recurrent soft tissue sarcoma arising in a previously radiated field. Cancer J Sci Am 1999, 5:26. [see comments].
95. Pickering D.G., Stewart J.S., Rampling R., et al. Fast neutron therapy for soft tissue sarcoma. Int J Radiat Oncol Biol Phys 1987, 13:1489.
96. Schmitt G., Pape H., Zamboglou N. Long term results of neutron- and neutron-boost irradiation of soft tissue sarcomas. Strahlenther Onkol 1990, 166:61.
97. Steingraber M., Lessel A., Jahn U. Fast neutron therapy in treatment of soft tissue sarcoma-the Berlin-Buch study. Bull Cancer Radiother 1996, 83:122s.
98. Goffman T., Tochner Z., Glatstein E. Primary treatment of large and massive adult sarcomas with iododeoxyuridine and aggressive hyperfractionated irradiation. Cancer 1991, 67:572.
99. Jakob J., Wenz F., Dinter D.J., et al. Preoperative intensity-modulated radiotherapy combined with temozolomide for locally advanced soft-tissue sarcoma. Int J Radiat Oncol Biol Phys 2009, 75:810.
100. Rhomberg W., Hassenstein E.O., 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.
101. Blay J.Y., von Mehren M., Samuels B.L., et al. Phase I combination study of trabectedin and doxorubicin in patients with soft-tissue sarcoma. Clin Cancer Res 2008, 14:6656.
102. Garcia-Carbonero R., Supko J.G., Maki R.G., et al. Ecteinascidin-743 (ET-743) for chemotherapy-naive patients with advanced soft tissue sarcomas: multicenter phase II and pharmacokinetic study. J Clin Oncol 2005, 23:5484.
103. Mendenhall W.M., Zlotecki R.A., Hochwald S.N., et al. Retroperitoneal soft tissue sarcoma. Cancer 2005, 104:669.
104. Pisters P.W., O'Sullivan B. Retroperitoneal sarcomas: combined modality treatment approaches. Curr Opin Oncol 2002, 14:400.
105. Lewis J.J., Leung D., Woodruff J.M., et al. Retroperitoneal soft-tissue sarcoma: analysis of 500 patients treated and followed at a single institution. Ann Surg 1998, 228:355.
106. Stoeckle E., Coindre J.M., Bonvalot S., 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.
107. Singer S., Antonescu C.R., Riedel E., et al. Histologic subtype and margin of resection predict pattern of recurrence and survival for retroperitoneal liposarcoma. Ann Surg 2003, 238:358.
108. van Dalen T., Hoekstra H.J., van Geel A.N., et al. Locoregional recurrence of retroperitoneal soft tissue sarcoma: second chance of cure for selected patients. Eur J Surg Oncol 2001, 27:564.
109. Russo P., Kim Y., Ravindran S., et al. Nephrectomy during operative management of retroperitoneal sarcoma. Ann Surg Oncol 1997, 4:421.
110. Petersen I.A., Haddock M.G., Donohue J.H., et al. Use of intraoperative electron beam radiotherapy in the management of retroperitoneal soft tissue sarcomas. Int J Radiat Oncol Biol Phys 2002, 52:469.
111. Jones J.J., Catton C.N., O'Sullivan B., et al. Initial results of a trial of preoperative external-beam radiation therapy and postoperative brachytherapy for retroperitoneal sarcoma. Ann Surg Oncol 2002, 9:346.
112. Gieschen H.L., Spiro I.J., Suit H.D., 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.
113. Eilber F.C., Rosen G., Nelson S.D., et al. High-grade extremity soft tissue sarcomas: factors predictive of local recurrence and its effect on morbidity and mortality. Ann Surg 2003, 237:218.
114. Tanabe K.K., Pollock R.E., Ellis L.M., et al. Influence of surgical margins on outcome in patients with preoperatively irradiated extremity soft tissue sarcomas. Cancer 1994, 73:1652.
115. Robertson J.M., Sondak V.K., Weiss S.A., et al. Preoperative radiation therapy and iododeoxyuridine for large retroperitoneal sarcomas. Int J Radiat Oncol Biol Phys 1995, 31:87.