Özet:

OBJECTIVES Prognostic factors were studied in 53 patients with soft tissue sarcoma treated with postoperative radiotherapy in Dokuz Eylül University Department of Radiation Oncology during the period November 1991-March 2003. METHODS Thirty of the patients (57%) were male. Median age was 38 (18-80). Thirty-three patients (62%) received their first diagnostic or surgical procedure in Dokuz Eylül University while the rest were referred from other institutions for postoperative radiotherapy. Tumor localization was as follows: 36 (68%) lower extremity, 6 (11%) upper extremity, 5 (10%) trunk, 6 (11%) head and neck. Twenty-nine patients (55%) had grade 1-2 tumors while 10 patients (19%) had grade 3 tumors. Histological grade could not be determined in 14 (26%) patients. Surgery was performed as wide excision, marginal or intralesional excision and excisional biopsy in 30 (57%), 15 (28%), and 8 (15%) patients, respectively. Surgical margins were reported as negative in 29 patients (55%). Gross residue was present in 15 patients (28%). Pathological tumor size was median 80 mm (15-220). Postoperative radiotherapy was given using two parallel opposed fields with Co 60 or 6 MVX photon energies. Median total radiotherapy dose was 6600 (4040-7500) cGy and median fraction dose was 200 (160-250) cGy. Adjuvant chemotherapy was added after postoperative radiotherapy in 14 patients who had high grade tumors and/or large tumor size. Survival times were calculated with Kaplan-Meier method considering the periods from the time of diagnosis. To find out prognostic factors, log-rank test and Cox regression test were applied in univariate and multivariate analyses, respectively. RESULTS Local control could not be achieved in 12 cases. Fifteen patients developed distant metastasis during follow-up. Five-year overall survival (OS) was 58%, respectively. In the multivariate analysis, OS was found to be independently influenced from tumor size <10 cm (p=0.02), addition of adjuvant chemotherapy (p=0.02), presence of local control (p=0.001) and absence of subsequent distant metastasis (p=0.001). CONCLUSION In our study OS was found to be affected independently by both local (presence of local control and tumor size) and systemic (addition of adjuvant chemotherapy, absence of subsequent distant metastasis) factors.

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