Preoperative Versus Postoperative Radiation Therapy in Patients with Soft Tissue Sarcomas

Purpose: To evaluate treatment outcome and to determine whether or not the timing of radiotherapy (RT) was associated with any difference in disease relapse, survival, or incidence of complications in patients with soft tissue sarcomas (STS). Methods: The medical files of 63 patients with a primary, nonmetastatic, STS, treated with surgery and irradiation were evaluated. Data regarding tumor stage, grade, site, dosage and timing of radiotherapy, treatment complications, disease relapse, and disease-free (DFS) and overall survival (OAS) rates were analyzed. Results: The median follow up was 47 months (range; 5-66 months). Four-year OAS and DFS rates were 82.6% and 78.8% respectively. There were significant higher 4-year OAS (p = 0.024) and DFS (p = 0.011) rates in patients with stage I and II diseases than those in patients with stage III disease. On the other hand, there were no significant differences in 4-year OAS (p = 0.83, HR: 0.743, 95% CI: 0.165 to 3.345) and DFS (p = 0.64, HR: 0.74, 95% CI: 0.21 to 2.61) rates between preoperative and postoperative RT patients. Disease relapse for preoperative versus postoperative RT patients was not statistically different (p = 0.41). Wound complications were more frequent in preoperative RT patients (25%) compared to postoperative RT patients (8%) (p = 0.0566 chi-square). Conclusions: Preoperative irradiation has not a positive impact on survival or disease relapse rates, but is associated with high wound complication rate.