Abstract | PURPOSE: METHODS: We reviewed the medical records of 71 consecutive patients treated with surgery and RT for localized MPNST between 1965 and 2012. Preoperative RT was used to treat 23 patients (32%) to a median dose of 50 Gy (range, 50 to 60 Gy), whereas 48 (68%) received postoperative RT to a median dose of 64 Gy (range, 45 to 70 Gy). RESULTS: Median follow-up for living patients was 118 months (range, 21 to 512 mo). The 5-year LC, distant metastatic free survival, and disease-specific survival rates were 84%, 62%, and 66%, respectively. To identify predictors of outcome, several multivariate models were constructed: (1) positive/uncertain surgical margin status was the only factor adversely associated local relapse at 5 years (28% vs. 5% for negative margins; P=0.02; hazard ratios 5.92; 95% confidence interval, 1.3-27.4). (2) No factors were significantly associated with distant metastatic free survival. Of the 35 patients (49%) who sustained disease relapse, only 3 were ultimately salvaged. Only 2 patients had grade 2 late toxicities ( necrosis, fibrosis) based on Common Terminology Criteria for Adverse Events version 4.03 criteria, and 1 patient had grade 1 edema. CONCLUSIONS: Combination therapy with surgery and RT provides favorable LC. Distant recurrences, however, continue to be challenging with limited salvage success at the time of relapse.
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Authors | Andrew J Bishop, Gunar K Zagars, Keila E Torres, Justin E Bird, Barry W Feig, B Ashleigh Guadagnolo |
Journal | American journal of clinical oncology
(Am J Clin Oncol)
Vol. 41
Issue 5
Pg. 465-470
(05 2018)
ISSN: 1537-453X [Electronic] United States |
PMID | 27281262
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoplasm Recurrence, Local
(mortality, pathology, therapy)
- Neurofibrosarcoma
(mortality, pathology, therapy)
- Prognosis
- Radiotherapy
(mortality)
- Retrospective Studies
- Salvage Therapy
- Surgical Procedures, Operative
(mortality)
- Survival Rate
- Young Adult
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